Language disorders: a functional approach to assessment and intervention [5th ed] 9780205607648, 0205607640, 3509420106189

Table of contents :
Cover......Page 1
Contents......Page 4
Preface......Page 10
Part 1 Introduction......Page 12
1 A Functional Language Approach......Page 14
Role of Pragmatics in Intervention......Page 19
Role of Generalization in Intervention......Page 21
Evidence-Based Practice......Page 28
Conclusion......Page 30
2 Language Impairments......Page 32
Diagnostic Categories......Page 33
Conclusion......Page 74
Part 2 Communication Assessment......Page 78
3 Assessment of Preschool and School-Age Children with Language Impairment......Page 80
Psychometric Versus Descriptive Procedures......Page 82
Psychometric Assessment Protocols......Page 84
Descriptive Approaches......Page 91
An Integrated Functional Assessment Strategy......Page 94
Conclusion......Page 109
4 Assessment of Preschool and School-Age Children with Language Difference......Page 110
State of Service Delivery......Page 112
Overcoming Bias in an Assessment......Page 118
An Integrated Model for Assessment......Page 122
Conclusion......Page 131
5 Language Sampling......Page 132
Planning and Collecting a Representative Sample......Page 133
Recording the Sample......Page 149
Transcribing the Sample......Page 151
Conclusion......Page 154
6 Analysis Across Utterances and Partners and by Communication Event......Page 156
Across Utterances and Partners......Page 158
Communication Event......Page 164
Conversational Partner......Page 184
Conclusion......Page 186
7 Analyzing a Language Sample at the Utterance Level......Page 187
Language Use......Page 188
Content......Page 195
Form......Page 203
Conclusion......Page 226
8 Narrative Analysis......Page 227
Collecting Narratives......Page 229
Narrative Analysis......Page 231
Children with CLD Backgrounds......Page 244
Narrative Collection and Analysis......Page 246
Conclusion......Page 247
Part 3 Intervention......Page 250
9 A Functional Intervention Model......Page 252
Principles......Page 254
Generalization Variables......Page 259
Conclusion......Page 276
10 Manipulating Context......Page 277
Nonlinguistic Contexts......Page 278
Linguistic Contexts......Page 280
Top-Down Teaching......Page 290
Conclusion......Page 292
11 Specific Intervention Techniques......Page 293
Pragmatics......Page 294
Semantics......Page 310
Syntax and Morphology......Page 333
Children with CLD Backgrounds......Page 344
Use of Microcomputers......Page 347
Conclusion......Page 349
12 Classroom Functional Intervention......Page 350
Background and Rationale: Recent Educational Changes......Page 351
Role of the Speech-Language Pathologist......Page 355
Elements of a Classroom Model......Page 357
Instituting a Classroom Model......Page 381
Conclusion......Page 385
13 Literacy Impairments: Language in a Visual Mode......Page 386
Reading......Page 388
Writing......Page 408
Conclusion......Page 419
A: Considerations for CLD Children......Page 420
B: Language Analysis Methods......Page 430
C: Selected English Morphological Prefixes and Suffixes......Page 454
D: Indirect Elicitation Techniques......Page 456
E: Intervention Activities and Language Targets......Page 460
F: Use of Children's Literature in Preschool Classrooms......Page 464
D......Page 478
L......Page 479
S......Page 480
W......Page 481
References......Page 482
B......Page 546
C......Page 547
D......Page 548
F......Page 549
H......Page 550
K......Page 551
L......Page 552
M......Page 553
P......Page 554
R......Page 555
S......Page 556
V......Page 557
W......Page 558
Z......Page 559
A......Page 560
C......Page 561
E......Page 564
I......Page 565
L......Page 567
M......Page 568
N......Page 569
P......Page 570
R......Page 571
S......Page 572
T......Page 574
W......Page 575
Z......Page 576

Citation preview

fifth edition

Language Disorders A Functional Approach to Assessment and Intervention Robert E. Owens, Jr. State University of New York at Geneseo

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HAM

13 12 11 10

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contents

Preface

ix

Part 1 Introduction 1

1

A Functional Language Approach

3

Role of Pragmatics in Intervention 8 Dimensions of Communication Context 9 Summary 10 Role of Generalization in Intervention 10 Variables That Affect Generalization 11 Summary 17 Evidence-Based Practice 17 Conclusion 19

2

Language Impairments

21

Diagnostic Categories 22 Information Processing 24 Mental Retardation or Intellectual Disability 26 Language Learning Disability 34 Specific Language Impairment 41 Pervasive Developmental Disorder/Autism Spectrum Disorder Brain Injury 55 Maltreatment: Neglect and Abuse 57 Other Language Impairments 61 Conclusion 63 Implications 64

Part 2 Communication Assessment 3

48

67

Assessment of Preschool and School-Age Children with Language Impairment 69 iii

iv

Contents

Psychometric Versus Descriptive Procedures 71 Psychometric Assessment Protocols 73 Test Differences 74 Content 74 Misuse of Normative Testing 75 Variables in Test Selection 79 Summary 80 Descriptive Approaches 80 Reliability and Validity 81 Summary 83 An Integrated Functional Assessment Strategy 83 Questionnaire, Interview, and Referral 84 Observation 85 Formal Testing 87 Sampling 97 Assessment for Information-Processing Deficits 98 Conclusion 98

4

Assessment of Preschool and School-Age Children with Language Difference 99 State of Service Delivery 101 Lack of Preparation and Experience 101 Unfamiliarity with Language and Culture 101 Lack of Appropriate Assessment Tools 106 Overcoming Bias in an Assessment 107 Use of Interpreters 108 Alternative Assessment 110 An Integrated Model for Assessment 111 Children with LEP 112 Children with Different Dialects 118 Summary 120 Conclusion 120

5

Language Sampling

121

Planning and Collecting a Representative Sample 122 Representativeness 122 A Variety of Language Contexts 123 Evocative Conversational Techniques 128 Language Sampling of Children with CLD Backgrounds Recording the Sample 138 Transcribing the Sample 140 Collecting Samples of Written Language 143 Conclusion 143

137

Contents

6

Analysis Across Utterances and Partners and by Communication Event 145 Across Utterances and Partners 147 Stylistic Variations 147 Referential Communication 148 Cohesive Devices 151 Communication Event 153 Social Versus Nonsocial 154 Conversational Initiation 155 Topic Initiation 156 Conversation and Topic Maintenance Duration of Topic 161 Topic Analysis Format 162 Turn Taking 166 Conversation and Topic Termination Conversational Breakdown 170 Conversational Partner 173 Conclusion 175

7

169

Analyzing a Language Sample at the Utterance Level Language Use 177 Disruptions 178 Intentions 179 Content 184 Lexical Items 185 Word Relationships 187 Figurative Language 190 Word Finding 191 Form 192 Quantitative Measures 192 Syntactic and Morphological Analysis Conclusion 215

8

158

Narrative Analysis

216

Scripts and Narrative Frames 218 Collecting Narratives 218 Narrative Analysis 220 Narrative Levels 221 High-Point Analysis 222 Story Grammars 224 Expressive Elaboration 227 Quantitative Measures 229 Cohesive Devices 230

197

176

v

vi

Contents

Reliability and Validity 232 Children with CLD Backgrounds Narrative Collection and Analysis Conclusion 236

Part 3 Intervention 9

233 235

239

A Functional Intervention Model

241

Principles 243 The Language Facilitator as Reinforcer 243 Close Approximation of Natural Learning 244 Following Developmental Guidelines 244 Following the Child’s Lead 246 Active Involvement of the Child 247 Heavy Influence of Context on Language 247 Familiar Events Providing Scripts 247 Designing a Generalization Plan First 248 Generalization Variables 248 Training Targets 248 Training Items 250 Method of Training 252 Language Facilitators 255 Training Cues 262 Contingencies 263 Location 264 Conclusion 265

10

Manipulating Context

266

Nonlinguistic Contexts 267 Linguistic Contexts 269 Modeling 270 Direct Linguistic Cues 272 Indirect Linguistic Cues 273 Contingencies 274 Top-Down Teaching 279 Conclusion 281

11

Specific Intervention Techniques Pragmatics 283 Intentions 284 Conversational Abilities

288

282

Contents

Narration 295 Semantics 299 Inadequate Vocabulary 300 Semantic Categories and Relational Words Word Retrieval and Categorization 311 Comprehension 315 Syntax and Morphology 322 Morphology 323 Verb Tensing 323 Pronouns 327 Plurals 328 Articles 328 Prepositions 329 Word Order and Sentence Types 330 Summary 331 Children with CLD Backgrounds 333 Use of Microcomputers 336 Conclusion 338

12

Classroom Functional Intervention

303

339

Background and Rationale: Recent Educational Changes Inclusion 341 Collaborative Teaching 342 Summary 343 Role of the Speech-Language Pathologist 344 Relating to Others 344 Language Intervention and Language Arts 345 Elements of a Classroom Model 346 Identification of Children at Risk 346 Curriculum-Based Intervention 353 Linguistic Awareness Intervention Within the Classroom Language Facilitation 365 Instituting a Classroom Model 370 Conclusion 374

13

Literacy Impairments: Language in a Visual Mode Reading 377 Reading Problems 377 Children with CLD Backgrounds Assessment of Reading 380 Intervention for Reading Impairment Writing 397 Writing Problems 397

379 385

340

358

375

vii

viii

Contents

Assessment of Writing 399 Intervention for Writing Impairment Conclusion 408

403

Appendices A

Considerations for CLD Children

B

Language Analysis Methods

C

Selected English Morphological Prefixes and Suffixes

D

Indirect Elicitation Techniques

E

Intervention Activities and Language Targets

F

Use of Children’s Literature in Preschool Classrooms Glossary References Author Index Subject Index

467 471 535 549

409 419 443

445 449 453

preface

T

he fifth edition of Language Disorders: A Functional Approach to Assessment and Intervention represents an exhaustive compilation of studies conducted by my professional colleagues and of several years of my own clinical work in speech-language pathology with both presymbolic and symbolic children and adults. In this book, I concentrate on children because of the special problems they exhibit in learning language. Adults who are acquiring language, or who have lost language and are attempting to regain it, represent a diverse group that would be difficult to address also in this text. I call the model of assessment and intervention presented in this text functional language. This approach goes by other names, such as environmental or conversational, and includes elements of several other models. Where I have borrowed someone’s model, ideas, or techniques, full credit is given to that person. I find assessment and intervention to be an adaptation of a little of this and a little of that within an overall theoretical framework. Readers should approach this text with this in mind. Some ideas presented are very practical and easy to implement, whereas others may not apply to particular intervention settings. Readers should use what they can, keeping in mind the overall model of using the natural environment and natural conversations as the context for training language. I am the first to acknowledge that I do not have a monopoly on assessment and intervention methods, nor do I pretend to have all of the answers. Within Language Disorders, I have made some content decisions that should be explained. I group all children with language problems, both delays and disorders, under the general rubric of language-impaired. This expedient decision was made recognizing that this text would not be addressing specific disorder populations except in a tangential manner. The fifth edition differs from previous ones in four ways beyond the obvious updating with the newest research. First, there is new emphasis on evidence-based practice (EBP), as there is throughout the profession of Speech-Language Pathology. In a special section I explain EBP in easy terms for students. Second, the chapter on disorders (Chapter 2) has been expanded to include the following: syndrome in recognition of the increased numbers of children being diag• Asperger’s nosed with this disorder. newest neurological data, which is changing our understanding of many disorders. • The Increased discussion of other low-incidence causes of language impairment (LI). •

ix

x

Preface

Third, I have increased discussion of children with culturally linguistically diverse (CLD) backgrounds throughout. These children are becoming an increasing portion of the preschool and school-age population in the United States. It is absolutely essential that future SLPs be aware of the issues of children with LI who come from CLD backgrounds. And finally, I have greatly expanded and rewritten the chapter on literacy (Chapter 13) because of the increasing importance of reading and writing in the caseloads of many school-based SLPs. With all this expansion, something had to go. Sadly, I have eliminated the sections on prelinguistic children and the special challenges they pose for SLPs. All is not lost, however, because I am planning to write a new text specifically addressing the needs of this population. The increasing need for early intervention (EI) dictates that we address this issue in its entirety and not as an add-on to other discussions. I hope that you will find this text useful. Those who use the methods found within these pages tell me that they and their clients find them to be useful, effective, adaptable, and fun. Time will tell if you agree.

Acknowledgments No text is written without the aid of other people. First, I thank the reviewers of this edition: Lynn Bliss, University of Houston; Louis De Maio, Minnesota State University; Adrienne McElroy-Bratcher, Eastern New Mexico University; and Kerri Phillips, Louisiana Technological University. I have tried to heed their sound advice. I also acknowledge the advice and counsel of Dr. Addie Haas, Department of Communication Disorders, State University of New York at New Paltz, a constant inspiration and breath of freshness and someone who helps me stretch my imagination and explore new possibilities. My many conference presentations and long hikes in the woods with Dr. Haas are always a learning experience and a joy. Linda Deats, a colleague at State University of New York and a dear friend, has offered constant encouragement and lots of laughs. In addition, special thanks and much love to my partner at O and M Education, Moon Byung Choon, for his patience, support, and perseverence. Other supporters include Dr. Linda House, chair, and Dr. Dale Metz and Irene Belyakov of the Department of Speech Pathology and Audiology, State University of New York at Geneseo. Finally, my deepest gratitude to Dr. James MacDonald, retired from the Department of Speech Pathology and Audiology, The Ohio State University, for introducing me to the potential of the environment in communication intervention. Thanks, Jim!

1 part

Introduction

C H A PTE R 1

A Functional Language Approach C H A PTE R 2

Language Impairments

This page intentionally left blank

1

chapter

A Functional Language Approach

4

Part 1 Introduction

A

t the risk of sounding like I think I’m something special, which I don’t and I’m not, let me begin with two vignettes. Several months ago I gave a presentation in Buffalo, New York, on a topic other than speech-language pathology and was pleased to see a former student sitting in the rear. Afterward, when I approached her and expressed my surprise at seeing her in attendance, she told me she was there not because of the topic but because she wanted to tell me how much she appreciated the functional intervention methodology I had shared with her in class ten years earlier. At the time, according to her, she thought I was describing a standard method of providing intervention and was not aware until she graduated just how different functional intervention is from typical intervention as practiced by her peers. She related to me that, ten years after graduating, she is still questioned by colleagues who wonder how she learned to make therapy look so natural and to engage children so well while genuinely seeming to enjoy herself. I can’t take credit for that. All I did was provide information. She is a bright, creative speech-language pathologist who was able to implement what she had learned. After another workshop in Connecticut, an older speech-language pathologist approached me to tell me she used many functional methods she had read in this book and found them to be very effective. Somewhat humbled, I thanked her, but as I moved on, she took my arm firmly and said,“You don’t understand. I get it. I get it.” As I turned back to her, she explained that functional intervention is not the same as using someone’s published language intervention program, it’s a philosophy of intervention that influences everything she does with children and adults with language impairment. Both women get it. In this book, we are going to explore that functional philosophy and how to implement it. I want you to get it too. There are many pieces to this model, but luckily, an inability to use some portions, such as working with parents, does not preclude using others, such as teaching through conversation. Nor does use of functional methods negate the need for more traditional methods with some clients and at some times during intervention. But with a functional approach firmly in your mind, you never lose sight of the goal. You never lose sight of intervention based on actual use of the newly trained skill to improve communication. All your clinical decisions move your clients in that direction. Throughout this book, to the best of my ability, I have used evidence-based practice (EBP) as the basis for this text. I have attempted to research each topic, weigh the data, and make informed decisions prior to passing the knowledge on to you. If you are unfamiliar with EBP, I’ll explain it at the end of the chapter. For now, let’s begin with the basic concepts of language impairment and functional language intervention. Language is a vehicle for communication and is primarily used in conversations. As such, language is the social tool that we use to accomplish our goals when we communicate. In other words, language can be viewed as a dynamic process. If we take this view, it changes our approach to language intervention. We become interested in the how more than in the what. It is that aspect of language intervention that I wish for us to explore through this book. The American Speech-Language-Hearing Association, the professional organization for speechlanguage pathologists, defines language disorder as follows: A LANGUAGE DISORDER is impaired comprehension and/or use of spoken, written and/or other symbol systems. This disorder may involve (1) the form of language (phonology, morphology, syntax), (2) the content of language (semantics), and/or (3) the function of language in communication (pragmatics) in any combination. (Ad Hoc Committee on Service Delivery in the Schools, 1993, p. 40)

Chapter 1

A Functional Language Approach

5

For our purposes, we shall consider the term language impairment to apply to a heterogeneous group of developmental disorders, acquired disorders, delays, or any combination of these principally characterized by deficits and/or immaturities in the use of spoken or written language for comprehension and/or production purposes that may involve the form, content, or function of language in any combination. Language impairment may persist across the lifetime of the individual and may vary in symptoms, manifestations, effects, and severity over time and as a consequence of context, content, and learning task. Language differences, such as those found in some individuals with limited English proficiency and with different dialects, do not in themselves constitute language impairments. In attempting to clarify the definition of language impairment, we have, no doubt, raised more questions than we have answered. For example, causal factors, such as prematurity, although important, are omitted from the definition because of their diverse nature and the lack of clear causal links in many children with language impairment (LI). In general, causal categories are not directly related to later language attributes (Lahey, 1988). Likewise, diagnostic categories, such as mental retardation, are not included in my definition for many of the same reasons. The definition also states that language differences are not disorders or delays, even though the general public and some professionals often confuse them. We explore all of these issues in Chapter 2 and the chapters that follow. For now, relax a little. The professional with primary responsibility for habilitation or rehabilitation of language impairment is the speech-language pathologist (SLP). The wearer of many hats, the SLP serves as team member, team teacher, teacher and parent trainer, and language facilitator. These many roles reflect a growing recognition that viewing the child and his or her communication as the problem is an outmoded concept, and increasingly, language intervention is becoming family centered or environmentally based, such as in a classroom. Professional concern is shifting from training targets such as individual morphological endings or vocabulary words to a more functional, holistic approach and broadening to a concern for the child’s overall communication effectiveness. A functional language approach to assessment and intervention, as described in this text, targets language used as a vehicle for communication. A functional approach is a communication-first approach. The focus is the overall communication of the child with language impairment and of those who communicate with the child. As stated, the goal is better communication that works in the client’s natural communicative contexts. An SLP needs to ensure that the language skills that are targeted and trained generalize to the everyday environment of the child. This concern for language use necessitates a new primacy for pragmatics and the interrelatedness of all aspects of language in intervention protocols. If all aspects of language are interrelated, then changes in one area affect others. For example, development in phonology (/s/) may affect morphological markers (plural -s). Syntactic growth may affect pragmatics. In intervention, such changes may not be spontaneous and must not be taken for granted. In general, it is best if an SLP not focus intervention solely in one aspect, such as syntax, to the exclusion of other aspects, such as pragmatics. In short, in a functional language approach, conversation between children and their communication partners becomes the vehicle for change. By manipulating the linguistic and nonlinguistic contexts within which a child’s utterances occur, the partner facilitates the use of certain structures and provides evaluative feedback while maintaining the conversational flow. From the early data collection stages through target selection to the intervention process, the SLP and other communication partners are concerned with the enhancement of overall communication.

6

Part 1 Introduction

Functional language approaches have been used to increase mean length of utterance and multiword utterance production; the overall quantity of spontaneous communication; pragmatic skills; vocabulary growth; language complexity; receptive labeling; and intelligibility and the use of trained forms in novel utterances in children with mental retardation, autism, specific language impairment, language learning disability, developmental delay, emotional and behavioral disorders, and multiple handicaps (Camarata, Nelson, & Camarata, 1994; Dyer, Williams, & Luce, 1991; Girolametto, 1988; Nye, Foster, & Seaman, 1987; Scherer & Olswang, 1989; Schwartz, Chapman, Terrell, Prelock, & Rowan, 1985; Theadore, Maher, & Prizant, 1990; Whitehurst, Fischel, Lonigan, Valdez-Menchaca, Arnold, et al., 1991). Even minimally symbolic children who require a more structured approach benefit from a conversational milieu (Owens, McNerney, Bigler-Burke, & Lepre-Clark, 1987; Yoder, Warren, et al., 1994). In addition, functional interactive approaches improve generalization even when the immediate results differ little from those of more direct instructional methods (Cole & Dale, 1986; RogersWarren & Warren, 1985; Warren & Kaiser, 1986a). Finally, a conversational approach yields more positive behaviors from the child, such as smiling, laughing, and engagement in activities, with significantly more verbal initiation, than does an imitation approach. In contrast, the child learning through an imitation approach is more likely to be quiet and passive (Haley, Camarata, & Nelson, 1994). In the past, language-training programs have focused on language form and content, with little consideration given to pragmatics or language use. As you know, form consists of syntax, morphology, and phonology; content is semantics or meaning; and pragmatics is use. The typical approach to teaching language forms has been a highly structured, behavioral one emphasizing the teaching of specific behaviors within a stimulus-response-reinforcement model (Fey, 1986). Thus, language is not a process but a product or response elicited by a stimulus or produced in anticipation of reinforcement. Stimulus-response-reinforcement models of intervention often take the form of questions by an SLP and answers by a child or directives by an SLP for a child to respond. Typical stimulus utterances by an SLP might include the following: Which one sounds better . . . or. . . . ? Did I say that correctly? Tell me the whole thing. Say that three times correctly. Consequences are based on the correctness of production and might include Good, Good talking, Repeat it again three times, Listen to me again, and so on. Table 1.1 contrasts the more structured, stimulus-response-reinforcement paradigm with a more functional approach. Many SLPs prefer structured approaches because they can predict accurately the response of the child with LI to the training stimuli. In addition, structured behavioral approaches increase the probability that the client will make the appropriate, desired response. Language lessons usually are scripted as drills and, therefore, are repetitive and predictable for the SLP. The child can become a passive learner as the SLP manipulates structured stimuli in order to elicit responses and dispense reinforcement. The SLP’s overall style is highly directive (Ripich & Panagos, 1985; Ripich & Spinelli, 1985). In other words, the clinical procedure is unidirectional. These “traineroriented” approaches (Fey, 1986) are inadequate for developing meaningful uses for the newly acquired language feature. Structured behavioral approaches that exhibit intensity, consistency, and organization have been successful in teaching some language skills. A major problem is generalization from clinical to more

Chapter 1

TABLE 1.1

A Functional Language Approach

7

Comparison of Traditional and Functional Intervention Models

Traditional Model

Functional Model

Individual or small group setting using artificial situations. Isolated linguistic constructs with little attention to the interrelationship of linguistic skills.

Individual or small- or large-group setting within contextually appropriate setting. Relationship of aspects of communication stressed through spontaneous conversational paradigm.

Intervention stresses modeling imitation, practice, and drill.

Conversational techniques stress message transmission and communication.

Little attention to the use of language as a social tool during intervention sessions.

The use of language to communicate is optimized during intervention sessions.

Little chance or opportunity to develop linguistic constructs not targeted for intervention.

Increased opportunity to develop a wide range of language structures and communication skills through spontaneous conversation and social interaction. Increased opportunity to develop communication skills by interacting with a wide variety of partners.

Little opportunity to interact verbally with others during intervention. Source: Adapted from Gullo & Gullo (1984).

natural contexts (Hunt & Goetz, 1988). For example, failure of language-training targets to generalize to other uses is one of the major criticisms of intervention with children with autism spectrum disorders (discussed in Chapter 2) (Koegel, 1995). Lack of generalization can be a function of the material selected for training, the learning characteristics of a child, or the design of the training. Stimuli present in the clinical setting that directly or indirectly affect the behavior being trained may not be found in other settings. Some of these stimuli, such as training cues, have intended effects, whereas others, such as an SLP’s presence, may have quite unintended ones. In addition, clinical cues or consequences used for teaching may be very different from those encountered in everyday situations, thus removing the motivation to use the behavior elsewhere. In contrast, functional approaches give more control to a child and decrease the amount of structure in intervention activities. Indices of improvement are in increased successful communication, rather than in the number of correct responses. Procedures used by an SLP and a child’s communication partners more closely resemble those in the language-learning environment of children developing typically. In addition, the everyday environment of a child with LI is also included in training. Naturally, the effectiveness of any language-teaching strategy will vary with the characteristics of the child with LI and the content of training. For example, children with learning disabilities seem to benefit more from specific language training than do other children with language impairment (Nye et al., 1987). Likewise, children with more severe LI initially benefit more from a structured imitative approach. In this chapter, we explore a rationale for a functional language approach. This rationale is based on the primacy of pragmatics in language and language intervention and on the generalization of language intervention to everyday contexts. Generalization is discussed in terms of the variables that influence it.

8

Part 1 Introduction

Role of Pragmatics in Intervention Pragmatics consists of the intentions or communication goals of each speaker and of the linguistic adjustments made by each speaker for the listener in order to accomplish these goals. Most features of language are affected by pragmatic aspects of the conversational context. For example, the selection of pronouns, verb tenses, articles, and adverbs or adverbial phrases of time involves more than syntactic and semantic considerations. The conversational partners must be aware of the preceding linguistic information and of each other’s point of reference. An earlier interest by SLPs in psycholinguistics has led to the present therapeutic emphasis on increasing syntactic complexity. An SLP’s role has been to discover each child’s individual learning strategies and to use these within the unidirectional, SLP-directed approach mentioned previously. With the therapeutic shift in interest to semantics or meaning in the early 1970s came a new recognition of the importance of cognitive or intellectual readiness but little understanding of the importance of the social environment. Most intervention approaches maintained structural behavioral teaching techniques. Cognitive process-based approaches were ignored or nonexistent. The influence of sociolinguistics and pragmatics in the late 1970s and 1980s has led to interest in conversational rules and contextual factors. Everyday contexts have provided a backdrop for explanations of linguistic performance. Among those working with special populations, the focus shifted to the communication process itself. Previously, for example, children’s behaviors were considered either appropriate or inappropriate to the stimulus-reinforcement situation, rather than as a part of the interaction. Echolalia and unusual language patterns considered inappropriate were extinguished or punished. When emphasis shifts to pragmatics and to the processes that underlie behavior, however, the child’s language, even echolalia, can be considered on its own terms. Older approaches tend to emphasize childrens’ deficits with the goal of fixing what’s wrong (Duchan, 1997). In contrast, a functional approach stresses what a child needs in order to accomplish his or her communication goals. It follows that intervention should provide contexts for actively engaging children in communication. In shifting the focus from the disorder to supporting a child’s communication, the goal becomes increasing support and opportunities for the child to participate in everyday communication situations. The natural outgrowth is to involve families and teachers in training programs. The traditional, or formalist, view of language—as a composite of various rule systems, consisting of syntax, morphology, phonology, semantics, and pragmatics (Figure 1.1)—may be inadequate. This approach has given way to a functional model and to a more holistic approach to intervention. Language is a social tool, and, as such, considerations of its use are paramount. The formalist model has been replaced by one in which pragmatics is the overall organizing framework. Increasingly, SLPs are recognizing that structure and content are influenced heavily by the conversational constraints of the communication context. This view of language necessitates a very different approach to language intervention. In effect, intervention has moved from an entity approach, which targets discrete isolated bits of language, to a systems or holistic approach, which targets language within the overall communication process (Norris & Hoffman, 1990a). The major implication is a change in both the targets and the methods of training. If, as formalists contend, pragmatics is just one of five equal aspects of language, then it offers yet another set of rules for training. Thus, there will be additional training goals, but the methodology need

Chapter 1

A Functional Language Approach

Formalist

Functionalist

Syntax

Pragmatics

9

Syntax

Phonology

logy Phon o

ogy

Morphology

phol Mor

Semantics Sema

ntics

tics gma

Pra

Pragmatics is one of five equal and interrelated aspects of language.

Pragmatics is the overall organizing aspect of language.

FIGURE 1.1 Relationship of the aspects of language.

not change. The training still can emphasize the what with little change in the how, which can continue in a structured behavioral paradigm. In contrast, an approach in which pragmatics is the organizing aspect of language necessitates a more interactive conversational training approach, one that mirrors the environment in which the language will be used. Therapy becomes bidirectional and child oriented, and conversation is viewed as both the teaching and transfer environment. DI M E NSIONS OF COM M U N ICATION CONTEXT Language is purposeful and takes place within a dynamic context. Context affects form and content and may, in turn, be affected by them. Context consists of a complex interaction of the following eight factors (Dudley-Marling & Rhodes, 1987): Purpose. Language users begin with a purpose that affects what to say and how to say it. Content. We use language to communicate about something. The topic of discourse will affect the form and the style. Type of discourse. Certain types of discourse, such as a debate or a speech, use a characteristic type of structure related to the purpose. Participant characteristics. Participant characteristics that affect context are background knowledge, roles, life experiences, moods, willingness to take risks, relative age, status, familiarity, and relationship in time and space. Setting. Setting includes the circumstances under which the language occurs. Activity. The activity in which the language users are engaged will affect language, especially the choice of vocabulary.

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Speech community. The speech community is that group with whom we share certain rules of language. It may be as large as the speakers of a language, such as English, or as small as two people who share a secret language of their own. Mode of discourse. The purpose and the relations of language users in time and space usually are determined by the mode of discourse. Speech and writing are modes that require very different types of interaction from the participants. Within a conversation, participants continually must assess these factors and their changing relationships. An SLP must be a master of the conversational context. Unfortunately, it is too easy to rely on overworked verbal cues, such as “Tell me about this picture” or “What do you want?” to elicit certain language structures. As simple a behavior as waiting can be an effective intervention tool when appropriate. Similarly, a seemingly nonclinical utterance, such as “Boy, that’s a beautiful red sweater,” can easily elicit negative constructions when directed at a child’s green socks. SLPs who know the dimensions of communication context understand these dimensions more effectively and manipulate them more efficiently. SU M MARY In the clinical setting, SLPs need to be aware of the effects of context on communication. How well children with LI regulate their relationships with other people depends on their ability to monitor aspects of the context. Given the dynamic nature of conversational contexts, it is essential that intervention also address generalization to the child’s everyday communication contexts.

Role of Generalization in Intervention One of the most difficult aspects of therapeutic intervention in speech-language pathology is generalization, or carryover, to nontraining situations (Fey, 1988; Halle, 1987; Hunt & Goetz, 1988; Warren, 1988). For our purposes, let us consider generalization to be the ongoing interactive process of clients and of their newly acquired language feature with the communication environment (Figure 1.2). For example, if we are trying to teach a child the new word doggie, we might repeat the word several times in the presence of the family dog and then cue the child with “Say doggie.” If the child repeats the word only in this situation, she has not learned to use the word. If she says the word spontaneously and in the presence of other dogs, however, then we can reasonably assume that the child can produce the word without a model and thus has learned the word. The trained content has generalized. The factors that affect generalization lie within the training content, the learner, and the teaching program and environment but will vary as particular aspects of the teaching situation change. If a response is to occur in a nontraining situation, such as a classroom, then some aspects of that situation should be present in the training situation to signal that the response should occur. In other words, an SLP must consider the effects of the various teaching contexts on generalization to everyday contexts. Time and again, we SLPs bemoan the fact that although Johnny performed correctly in therapy, he could not transfer this performance to the playground, classroom, or home. When language features taught in one setting are not generalized to other content and contexts, the goal of communicative competence is not realized.

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Newly learned behavior or language feature

Learner

Environment

Generalization is the interaction of the individual, the newly trained behavior or language feature, and the environment. All three must be present for generalization to occur.

FIGURE 1.2 Generalization schematic.

Some SLPs hope that the training will generalize but exercise little influence over that possibility. This condition reflects a failure to manipulate the variables that affect generalization. Language training may not generalize because it is taught out of context, represents neither a child’s communicative functions nor linguistic knowledge or experiences, or presents few communicative opportunities. To some extent, generalization is also a result of the procedures used and of the variables manipulated in language training. Finally, the very targets chosen for remediation may contribute to a lack of carryover. With each client, an SLP needs to ask: Will this procedure (or target) work in the child’s everyday environment? Is there a need within the everyday communication of the client for the feature that is being trained, and do the methods used in its teaching reflect that everyday context? In a recent meeting with a student SLP, the answer to these questions was no. As a result, we decided to forgo auxiliary verb training with a middle-aged adult with mental retardation in favor of communication features more likely to be used within the client’s everyday communication environment, such as ordering at a fast-food restaurant, asking directions, and using the telephone. In other words, we opted for a more functional approach that targeted useful skills in the everyday environment of the client. VAR IAB LES THAT AFFECT G E N E RALIZATION Generalization is an essential part of learning. Even the young child using his or her first word must learn to generalize its use to novel content. At first the word doggie may be used with other four-legged

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animals. Eventually, the child abstracts those cases in which the word doggie is correct and those in which it is not. The child is learning those contexts that obligate the use of doggie and those that preclude its use. Contexts regulate application of language rules. Likewise, a young child who can say,“May I have a cookie, please?” has not learned this new utterance until it is used in the appropriate contexts. A child learns the appropriate contextual cues, such as the presence of cookies, that govern use of the utterance. The contexts in which training takes place influence what a child actually learns. In fact, correctness is not inherent in a child’s response itself but is found in the response in context. Saying “May I have a cookie, please?” when none are available is inappropriate. The relationship of context to learning is not a simple one, and the stimuli controlling a response may be multiple. Generalization is also an integral part of the language intervention process. Thoughts on generalization should not be left until after the intervention program is designed. Generalization is not a single-line entry at the end of the lesson plan, nor is it homework. To facilitate the acquisition of truly functional language—language that works for the child—it is essential that SLPs manipulate the variables related to generalization throughout the therapeutic process. In the functional model, generalization is an essential element at every step. Table 1.2 includes a list of the major generalization variables. Generalizations are of two broad types: content generalization and context generalization. Content is the what of training. Content generalization occurs when the child with LI induces a language rule from examples and from actual use. Thus, the new feature (e.g., plural -s) may be used with content not previously trained, such as words not used in the therapy situation. Content generalization is affected by the targets chosen for training, such as the use of negatives, and by the specific choice of training items, such as the words and sentences used to train negation. Overall, the content selected for training reflects an SLP’s theoretical concept of language and of strategies for learning and the communication needs of a child. When grammatical units are targeted, different uses or functions for those units are essential to meet a child’s needs. If content is the what, context is the how of training. Context generalization occurs when the client uses the new feature, such as the use of auxiliary verbs in questions, within everyday communication, such as in the classroom, at home, or in play. In each of these contexts are differences in persons present and in the location, as well as in the linguistic events that precede and follow the newly learned behavior. Generalization can be facilitated when the communication contexts of the training environment and of the natural environment are similar in some way. Context includes an intrapersonal component unique to each individual and an interpersonal component shared by all persons in the communication setting (Spinelli & Terrell, 1984). Intrapersonal TABLE 1.2

Variables That Affect Generalization of Language Training

Content generalization

Training targets Training items

Context generalization

Method of training Language facilitators Training cues Consequences Location of training

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variables include each partner’s cognitive and social knowledge or context, variables that may differ greatly. These variables influence intervention decisions on the selection of content and the individualization of program design. Interpersonal variables include situational factors (e.g., method of training, personnel involved, training cues, reinforcement method, location and time of training, and objects present) and participant factors (e.g., conversational roles of the participants). The effects of some of these variables on generalization are discussed in detail in the following sections. Training Targets The very complexity of language makes it impossible for an SLP to teach everything that a child with LI needs to become a competent communicator. Obviously, some language features must be ignored. Target selection, therefore, is a conscious process with far-reaching implications. Training target selection should be based on the actual needs and interests of each child within his or her communication environments. The focus of instruction should be on increasing the effectiveness of child-initiated communication. Because language is a dynamic process that is influenced heavily by context, language features selected for training should be functional or useful for the child in the communication environment. Although there is a tendency for beginning SLPs to target specific language deficits, such as plural -s, as an end in itself, intervention goals must focus on stimulating the language acquisition process beyond the immediate target (Fey, Long, & Finestack, 2003). We can best serve children with LI if we enhance each child’s existing resources for learning language more effectively not only within the intervention context but beyond. Not all language features occur with equal frequency. It may be necessary, therefore, to create more frequent opportunities for a feature to occur. An SLP must create activities and modify the environment to increase the need for the target feature. Generalization is also a function of the scope of the training target and of the child’s characteristics and linguistic experience with the target. In general, language rules with broad scope generalize more easily than those with more restricted scope (Kamhi, 1988). The scope of rule application can be a function of the way it is taught. Narrow, restricted teaching reduces training targets to easily identifiable and observable units. Rules interpreted by a child as applying to a limited set of items combined in a very specific manner will involve little generalization (Johnston, 1988a). The child’s prior knowledge of language also influences generalization. The failure of training to generalize may reflect training targets that are inappropriate for the knowledge level of a child. For example, it would be inappropriate to train indirect commands (e.g., can you . . . ?) prior to the child’s understanding and using yes/no questions and direct commands. In conclusion, training targets should be selected on the basis of each child’s actual communication needs and abilities, rather than on some preconceived agenda. The targets selected for training should be functional or useful in a client’s everyday communication environment. Training Items The actual items selected for intervention, such as the specific verbs to be used in training the past tense or the sentences to be used in training negation, and the linguistic complexity of these intervention

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Part 1 Introduction

items also can influence generalization. In general, it is best if these items come from the natural communication environment of the child with LI. Structured observation of this environment can aid intervention programming. For example, an active child may use the verbs walk, jump, and hop frequently. It is more likely that use of the past-tense -ed will generalize if these frequently occurring words are used in the training. Individualization is important because of the many potentially different use environments. A child who is institutionalized may have very different content to discuss than does a child who resides at home. The interests of younger children are also very different from those of adolescents. Targeted linguistic forms, whether word classes or larger linguistic structures, can be trained across several functions. For example, negatives used with auxiliary verbs can occur in declaratives (“That doesn’t fit”), imperatives (“Don’t touch that”), and interrogatives (“Don’t you want to go?”) and in functions, such as denying (“I didn’t do it”) or requesting information (“Why didn’t you go?”). For optimum generalization, then, it is necessary to select training items from a child’s everyday environment. In addition, these items should be trained across linguistic forms and/or functions and across linguistic and nonlinguistic contexts. Method of Training The training of discrete bits of language devoid of the communication context actually may retard learning and growth (Damico, 1988; N. Nelson, 1993). Such fragmentation allows minute analysis units to eclipse the essential language qualities of intentionality and synergy (Damico, 1988). In other words, language use in communication is lost. Intervention that focuses on these specific, discrete, structural entities fosters drills and didactic training. These adversely affect the flow, intentionality, and meaningfulness of language (Oller, 1983). If language is viewed holistically, then the training of language involves much more than just training words and structures. Clients learn strategies for comprehending language directed at them and for generating novel utterances within several conversational contexts. Training should occur in actual use within a conversational context. Prutting (1983) states that language intervention should meet the “Bubba” criterion. Bubba is Yiddish for “grandmother.” If we were to explain our intervention approach to our Jewish grandmother, she would reply: “Oh, I could have told you that. It just makes sense to use conversations to train. Why didn’t you ask me?” In other words, the training regimen should make sense. Training in context makes sense. Our intervention methodology should flow logically from our concept of language. If language is a social tool and if the goal is to train for generalized use, then it follows that language should be trained in conditions similar to the ultimate use environment. Thus, an SLP modifies the interactional context within which language is trained so that it closely resembles or actually takes place within a child’s ongoing everyday communication. It is important, therefore, to view context not as a backdrop but as an ongoing process. Conversational methods alone will not guarantee success for every child with LI. For example, children with ASD, previously called autism, can improve social relationships better through a combination of peer training and written text cueing than by either method singularly (Thiemann & Goldstein, 2004). An SLP can blend these methods together as required by a child in order to be successful. Discussion of the method of training leads naturally to consideration of the other contextual variables. For optimum generalization, training should occur within a conversational context with varying numbers of facilitators, cues, consequences, and locations.

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Language Facilitators Language facilitators are “adults who increase the child’s potential for communication success” (Craig, 1983, p. 110). Parents, teachers, aides, and unit personnel, in addition to the SLP, should act as language facilitators because of their relationship with and the amount of time each spends with the child. Interactional partners form communication environments for each other, and it is essential that the client experience newly learned language in a number of these. Because language is contextually variable, it will differ within the context created by a child with each communication partner. Thus, generalization depends on the number of communication partners we can involve in the intervention process (Craig, 1983). For children developing typically, the number of individuals they see during the day or week is positively correlated with the rate of language development (K. Nelson, 1973). Programs that involve a child’s communication partners, especially parents, produce greater gains for children than do programs that do not. Parents offer a channel for generalizing to the natural environment of the home. With parent or caregiver training, both parents and teachers can function on a continuum from paraprofessionals to general language facilitators (Adler, 1988; McDade & Varnedoe, 1987; Owens, 1982d). The key in working with families, especially in early intervention with infants and toddlers, is mutual respect and individualization of services based on each family’s priorities and concerns (Sandall, McLean, & Smith, 2001). Some cultural beliefs may be at variance with the use of parents as language facilitators. For example, some Mexican American mothers believe that schools have the main responsibility for educating children and that parents should not be actively involved (Rodriguez & Olswang, 2003). These same mothers are more likely than Anglo American mothers to attribute LI to factors external to the child, such as God’s will or a child–school mismatch. Still, these mothers can eventually be enticed into taking an active role in language intervention if an SLP builds positive rapport and collaboration and is respectful of culturally held beliefs. Intervention need not be limited to just families. When daycare staff are trained to respond to children’s initiations, to engage children, to model simplified language, and to encourage peer interactions, it has a significant effect on the language production of preschool children (Girolametto, Weitzman, & Greenberg, 2003). With these additional language facilitators, the traditional role of an SLP changes. In essence, the SLP becomes a programmer of a child’s environment, manipulating the variables to ensure successful communication and generalization. To be effective, an SLP needs to recognize that a child’s communication partners are also clients, as well as agents of change (MacDonald, 1985). The SLP acts as a consultant, helping each child-parent dyad fine-tune its conversational behaviors. Training Cues Goals for the child should include both initiating and responding behaviors in the situations in which each is appropriate. Therefore, an SLP considers training language through a great variety of both linguistic and nonlinguistic cues. For example, results of several studies of intervention with young children with autism spectrum disorder (ASD) indicate that those interventions that are most successful use modification of the natural environment to prompt and cue communication and use natural reinforcers. The adult encourages child utterances by subtle manipulation of the context and responds to the child in a conversational manner. A functional language approach adapts these techniques as naturally as possible to intervention.

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Contingencies The nature of the reinforcement used in training is also a strong determiner of generalization. Everyday, natural consequences are best. If the child requests a paintbrush, she should be given one, unless, of course, there is a good reason not to give it. If that is the case, then the child should not have been required to learn that request. Weaning the child away from edible or tangible reinforcers in favor of social ones is commendable as long as the social reinforcer is found in the natural communication environment. Verbal or social training consequences such as “Good talking,” encountered only rarely in the course of everyday conversations, should be discontinued as soon as possible in favor of more natural responses. Verbal responses that combine feedback about correctness/incorrectness with additional information can be both a language-learning opportunity and a communicative turn while maintaining the conversational flow. “Good talking” ends social interaction by commenting on the correctness of the child’s utterance only and leaving little that the child can say in return. Not every utterance is reinforced in the natural environment. In the course of everyday conversations, many utterances are not reinforced. In typical language intervention, however, every utterance by the child may be reinforced. Behaviors continuously reinforced are easy to extinguish. Intermittently reinforced responses are much more resistant and more closely resemble patterns found in the real world. Location The location of training involves not only places but also events. For maximum generalization, language should be trained in the locations, such as the home, clinic, school, or unit, and in the activities in which it is used, such as play or household chores. Children removed from familiar contexts may not exhibit their most creative language uses (Lieven, 1984). Language should be trained within the daily activities of the client. Daily routines can provide a familiar framework within which conversation can occur. The familiar situation provides a frame that allows for a degree of automatization important in the acquisition of such skills as language. Often called incidental teaching, this approach attempts to ensure that children learn and have ample opportunity to use language within naturally occurring activities (McCormick, 1986; Owens, 1982d; Warren & Rogers-Warren, 1985). Generalization increases with the similarity of the original learning situation to the transfer situation. If the conditions for training and use are the same, the need for contrived generalization strategies is alleviated. In addition, embedding intervention within the everyday routines and activities of the home or classroom focuses on generalization while reducing the stress for families and teachers that accompanies specialized training procedures (Dunlap & Fox, 1999). The ideal training situation is one in which a child with LI is engaged in some meaningful activity with a conversational partner who models appropriate language forms and functions (Staab, 1983). In this way, a child learns language in the conversational context in which it is likely to occur. It is within these everyday events that language is acquired naturally and to these events that the newly trained language is to generalize. Within these daily events are naturally occurring communication sequences (Craig, 1983). Daily events, such as phone calls, friendly meetings, dinner preparation, and even dressing, can provide a framework for language and for language training. The frame provides a guide to help the participants organize their language and their language learning. Routines and familiar situations provide support

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(Lieven, 1984). An SLP can plan conversational roles and language training through the use of such daily events.

SU M MARY A basic goal of intervention should be to help a child achieve greater flexibility in the learning and use of language in written and oral modalities of comprehension and production. Such language intervention can be a dynamic process of exchange that occurs during natural events in different environments and with different conversational partners. Reinforcement can be the intrinsic conversational success of a child. The variables relative to content and context can, if manipulated carefully, facilitate generalization of newly learned language features and make intervention seem more natural. Unfortunately, in practice, generalization is too often the final step in planning client training. Instead,“communication goals and effects should be preserved and considered the first, pervasive, and most basic step in intervention planning” (Craig, 1983, p. 110).

Evidence-Based Practice As clinicians, of course, we should be concerned with providing the best, most well-grounded intervention for our clients that is humanly possible. In other words, we should do what works or is effective. Discerning efficacy and providing the most efficacious intervention is a portion of something called evidence-based practice (EBP). In EBP, clinical decision making is informed by a combination of scientific evidence, clinical experience, and client needs. Research is combined with reason when making decisions about treatment approaches. Evidence-based practice is based on two assumptions (Bernstein Ratner, 2006): skills should grow from the current available data, not simply from experience. • Clinical The expert SLP should continually seek new therapeutic information to improve efficacy. • In the field of speech-language pathology, interest in EBP is relatively new, and there are few guidelines on providing services. Although the American Speech-Language-Hearing Association (ASHA) has established the National Center for Evidence-Based Practice in Communication Disorders, it will take years to establish comprehensive assessment and intervention guidelines. In other words, for now, EBP is a work in progress. That does not relieve SLPs of the responsibility to provide the best, most efficacious assessment and intervention possible. Until such time as guidelines do exist, SLPs need to base decisions on the best available evidence. Not all clinical evidence is created equal. Professional journals, called peer-reviewed journals, in which each submitted manuscript is critiqued by other experts in the field and accepted or rejected on the basis of the quality of the research, would seem to be the best source of information. Unfortunately, in the field of speech-language pathology, only a small percentage of the articles concern intervention efficacy. Once research has been located, an SLP is left to decide how much information is enough, how to resolve seemingly conflicting results, and how to adapt the information to individual clients.

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It is also important for SLPs to recognize that efficacy is never an all-or-nothing proposition (Law, 2004; Rescorla, 2005). We cannot, for example, promise a “cure.”As an old-timer, I’ve had one knee and one shoulder rebuilt, and although these joints now function better than they did prior to surgery and physical therapy, they are not the joints I had when I was 20. I have regained a portion of my former strength and agility, but it is not perfect. Neither is our intervention in speech-language pathology, especially given the variables that can affect communication development. This fact makes careful understanding and application of recommended intervention techniques critical. The decision-making process in EBP is systematic and includes the following several steps (Gillam & Gillam, 2006; Perzsolt, Ohletz, Gardner, Ruatti, Meier, et al., 2003): the information needed and ask the correct clinical question. Questions should • Determine include information on the client’s performance, the environment, the intervention approach,

• •

• • •

and the desired outcomes. Find studies that address the clinical question. When searching for information, many SLPs consult the Internet. The ASHA website is a valuable resource for articles published in ASHA journals and hundreds of other affiliated journals. Effective use of the Internet is addressed below. Determine the level of evidence, and critically evaluate the studies. The quality of information differs and should be prioritized by an SLP. First-order information includes research articles in peer-reviewed professional journals. Other information, such as single-subject or small-group reports, archival records, committee reports, conference proceedings, and opinion papers, should be given less weight. In general, the best research compares the efficacy of similar groups to which children have been randomly assigned so as not to bias the results. It is best if data collectors do not know to which group children are assigned and use valid and reliable measures of performance. Finally, statistical evidence should find that, at a probability (p) of .05 or less, the results would not occur by chance. Because the p value may be meaningless at this point, and it’s beyond the scope of this text to discuss probability theory, for now just know that authors report the p value in their research. An SLP must also determine that the participants in the study compare well with the specific child in his or her clinical question. Evaluate the information for the specific case in question. Issues include the associated costs of intervention in time and money, cultural variables of the child and family, student-parent involvement and opinions, client interests, and agency policies and philosophy. Integrate the information and make a decision. Evaluate treatment outcomes to measure efficacy. Of special significance is the use of the targeted language features in everyday natural speaking situations.

These steps alone will not guarantee the best outcome, but they do provide a systematic method for decision making. Because of the potential for misinformation from many sources when researching on the Internet, it is important that an SLP use the most appropriate methods for investigating and retrieving information. Search engines such as Google and Yahoo search the entire open Internet and often provide information from secondary or tertiary sources or information that is not based on peer-reviewed research at all. It’s important to know who authored the information and/or sponsors the site, the purpose and nature of the site, and the currency of the information (Nail-Chiwetula & Bernstein Ratner, 2006). For example, a site sponsored by an intervention materials company may try to promote inter-

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vention methods using their materials. Even academic (.edu) or government (.gov) sites may present non-peer-reviewed information. For example, educational sites may present student papers submitted for specific courses. Useful professional sites include the following: The American Speech Language Hearing Association (www.asha.org/topicindex.htm) offers full text of all articles in its journals for ASHA or NSSLHA members. PubMed (www.ncbi.nlm.nih.gov/entrez/query.fcgi) is a free database offered by the National Library of Medicine. Full-text articles are unavailable. Many university libraries offer several databases relevant to speech-language pathology, including CINAHL, ERIC, Language and Language Behavior Abstracts (LLBA), MEDLINE, and PsycINFO. Many offer full-text access. Abstracts do not provide sufficient information for evaluating the quality of research reported. Searches may yield thousands of entries. It is important that an SLP limit the search in order to yield only the most relevant information. For example, a search term such as autism will result in too many references to be useful, unless an SLP has years to sort through the data. Additional words, such as child, language, and assessment will further limit the search. Exact phrases can be placed in parentheses, as in (autism spectrum disorder), so that results will be limited to those words in that order. Searches can be expanded by using an asterisk after the word, as in child*. Search engines then treat child as a root word and will also search children and childhood. Journal searches may be limited by year and author as well. SLPs should be careful with common acronyms that may have other references. Even ASHA yields results other than the American Speech-Language-Hearing Association. Specific techniques for limiting or expanding searches are usually included in the search engine’s Help section.

Conclusion A functional approach emphasizes nurturant and naturalistic methods (Duchan & Weitzner-Lin, 1987). The nurturant aspect requires an SLP/facilitator to relinquish control to the child and to respond to the child’s communication initiations. The naturalistic aspect emphasizes everyday events and context because language makes sense only when used within a communication context. The SLP becomes a master in the manipulation of that context in order to facilitate communication and generalization. Language is trained while it is actually used in everyday contexts. As a result, the training generalizes. Learning and generalization are the result of good planning based on a knowledge of the variables that affect generalization and the individual needs of each child. The content selected for training and the context within which this training takes place are both important aspects of the generalization process. The SLP helps the child determine the best response to fulfill his or her initiations within contexts that facilitate his or her intervention targets. Although the role of an SLP within the functional language paradigm changes from primary direct service provider to language facilitator and consultant, the SLP still has primary responsibility for planning and implementing intervention. Some professionals cast a wary eye on implementation of such conversational and communicationbased approaches to language intervention. The fear is that intervention will deteriorate into a “Hey, man, what’s happenin’?” approach, too open-ended to be effective in changing client behavior. Although

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this danger does exist, it is not inherent in functional approaches. As this text progresses, we discuss assessment and training procedures that enable SLPs to maintain a teaching momentum within the more natural context of conversation. It’s productive, fun, and evidence based. In the following chapters, we explore LIs, assessment, and intervention. After a discussion of children with LIs, we discuss the assessment process and the collection and analysis of conversational and narrative data. In the following chapters, an intervention paradigm and various techniques are presented, along with discussion of special applications to the classroom environment and to literacy.

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Language Impairments

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Part 1 Introduction

What’s wrong, Juan? You seem upset. Took them things. Who did, honey? What? That boy. Which one? Show me. Him. (points) Him took thems. Timmy? Timmy took something? (nods affirmatively) Thems! What? I don’t see anything. Thems, thems things that I build. Oh, Timmy took your Legos? Timmy took your Legos. Obviously, we have a communication breakdown. Juan, at age 8, is unable to communicate the simple concept Timmy took my Legos. Juan has a language impairment. Juan, like many of the children described in this chapter, may have impairments in other areas of development as well. For example, children with mental retardation are going to experience slower maturity in all developmental areas, not just language. It is also reported that some children with LI have nonverbal deficits in identifying an object after it has been rotated, in analogies (A is to B as C is to _____), and in rapidly repetitive manual motor tasks (Swisher, Plante, & Lowell, 1994). This and other reported differences may reflect actual deficits or may be confounded by the linguistic aspects of these tasks (Casby, 1997). We still have much to learn from these children. In this chapter, we’ll discuss the most common diagnostic categories of children with LI. I attempt to personalize this discussion whenever possible, but readers should remember that we are examining groups of children, not individuals. For example, no one child with a language learning disability may exhibit all of the characteristics ascribed to these children. I’ll try to explain commonalities and differences across various disorders and to explore the most common language problems seen by SLPs.

Diagnostic Categories Many categories of disability have language components. In this section, we discuss some of these categories in detail, attempting to describe both similarities and differences. Typical language learning requires the following (Johnston, 1991): 1. 2. 3. 4. 5.

The ability to perceive sequenced acoustic events of short duration The ability to attend actively, to be responsive, and to anticipate stimuli The ability to use symbols The ability to invent syntax from the language of the environment Enough mental energy to do all of the above simultaneously

Because language is learned naturally from another person in the course of conversation, let’s add an additional requirement: 6. The ability to interact and communicate with others

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Many of the children described in the following section have problems in one or more of these areas. As we discuss each language impairment, try to keep these abilities in mind. There is a danger in describing categories of children and then assigning children to these categories. In general, such categories are helpful for discussion, but there is a danger that the category can become self-fulfilling. Children assigned to the category then are treated as the category, not as individuals. It is important to remember that the child is not mentally retarded, but rather is a child with mental retardation. Discussing of LI categories can also cause us to overlook the similarities that exist between children classified by different categories. Many assessment and intervention strategies and techniques can be used across children. Many children with LI cannot be described easily by any of the categories discussed in this chapter. Such children may have either more than one primary diagnostic category or characteristics that do not fit into any category. Each child represents a unique set of circumstances, so language assessment and intervention should be individualized. Within each disorder category below, we will limit the discussion to general characteristics, language characteristics, and possible causal factors. Although causal influences vary widely, studies of twins suggest a strong genetic component for many language impairments, especially more severe deficits (DeThorne, Petrill, Hayiou-Thomas, & Plomin, 2005; Segebart DeThorne, Hart, Petrill, DeaterDeckard, Thompson, et al., 2006). Perception and learning style also are important, as is environmental input. For example, while typically developing children use one aspect of language to facilitate learning another, such as using semantic knowledge to aid syntactic learning, in a process called bootstrapping, children with LI, especially late-talkers, may have different learning styles and use these learning strategies less frequently and/or less effectively (Jones Moyle, Ellis Weismer, Evans, & Lindstrom, 2007). In general, mothers of children diagnosed with LI initially at age 3 and then again at age 41⁄2 are less sensitive and exhibit more depression than mothers of children whose LI had been resolved by this time (La Paro, Justice, Skibbe, & Planta 2004). Measures of maternal sensitivity include to what degree a mother is a supportive presence, respects her child’s autonomy, and expresses hostility. This suggests the importance of a mother–child relationship in the language growth of preschool children with LI. Any discussion of LI may miss these subtle differences and their affect on a child with LI. Disorders and delays do not solely reside in the child. Unfortunately, we will be unable to discuss all possible language impairments. Some identifiable disorders have been omitted because of the small numbers of children or the paucity of research data. Others—for example, Tourette syndrome, a neurological movement disorder that affects up to 3 percent of children and consists of uncontrolled motor and phonic tics (Jankovic, 2001)—have been omitted because concomitant behaviors place the disorder in a somewhat specialized category and because language impairment is tangential to the primary disorder. In addition, language impairments resulting from low birth weight, prolonged hospitalization, or multiple births are not discussed separately and can be found within other categories described in this chapter (Bishop & Bishop, 1998; Hemphill, Uccelli, Winner, Chang, & Bellinger, 2002; Tomblin & Buckwalter, 1998). Finally, deafness has also been omitted because of the very broad range of issues relative to hearing, speech, and language. Issues of deafness deserve their own text. At the end of the chapter, I’ll make a few brief remarks on some of the categories of LI that have been omitted from the more detailed explanations to follow.

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Part 1 Introduction

I N FOR MATION PROCESSI NG Prior to discussing specific disorders, it may be helpful to quickly review the information processing system that serves both thought and language. New research is indicating the importance for both language development and language impairment of this system and of the processing of information. Each individual processes information in a somewhat different manner. These differences can be explained by structural differences in individual brains and by learned differences, such as the way in which each of us approaches new information or problem solving. These learned differences influence, among other things, decisions about attending, schemes for organization, and rules and strategies for handling information. Information processing can be divided into four steps: attention, discrimination, organization, and memory or retrieval. These are presented in Figure 2.1. Attention includes automatic activation of the brain, orientation that focuses awareness, and focus (Cowan, 1995). When the brain focuses on a stimulus, a neural or mental “model” is formed in working memory that allows further processing to occur. We do not attend to all possible stimuli, as can be noted in Stimulus D in Figure 2.1. A child with poor attending skills may not pay attention to important stimuli, with the result that he or she will have poor discrimination. In order to discriminate both likenesses and dissimilarity we need to observe or attend for short periods. Discrimination is the ability to identify stimuli from a field of competing stimuli. Decisions are made on the similarity or dissimilarity of stimuli based on the “model” in working memory. In Figure 2.1, Stimuli B and C are perceived to be similar to each other and to information previously stored in Area 2, a fictitious location in the brain. Incoming linguistic information undergoes two types of synthesis: simultaneous and successive. Simultaneous coding is related to higher thought, and separate elements of the message are synthesized into groups so that all members are retrieved simultaneously. Overall meaning of the message is coded.

Executive Function Near transfer Long-term memory

Working memory A S B T I C M U L D I E F

A t t e n t i o n

D i s c r i m i n a t i o n

New problem

B=C=2

Needs immediate response New problem

O r g a n i z a t i o n

1 2 3 RETRIEVAL

Memory

4 5 6

Far transfer

FIGURE 2.1

Schematic representation of information processing.

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In contrast, successive coding occurs in linear fashion, one at a time. Language is processed at the unit level rather than holistically. Both processes are used for decoding and encoding of linguistic and nonlinguistic information. Organization is the categorization of information for storage and later retrieval. Information that is organized is more easily retrievable. Material that is unorganized or poorly organized will hinder later recall and quickly overload memory capacity. More efficient processing requires increasingly better organization, which, in turn, leaves room for more information. In this fashion, capacity for long-term storage becomes virtually unlimited. It would be erroneous to think of storage as simply filing of information. Information is stored in networks that relate to all aspects of stored information. The more associations formed, the better memory and retrieval function. Memory is the retrieval of information. The capacity for storage and the speed and accuracy of retrieval increases with maturity. Retrieval is limited and dependent on environmental cues, the frequency of previous retrieval, competition from other memory items, and the age of learned information. All else being equal, it is easiest to retrieve information that has been frequently retrieved, has few competing memory items, has distinct environmental cues, and was learned recently and well. Although not one of the four steps, transfer, or generalization—the application of learned material to previously unlearned information or to new contexts—is important for learning. Transfer exists along a continuum of near to far. Near transfer involves only minimal difference between known information and the new problem. In contrast, far transfer involves substantial difference. Both types are represented in Figure 2.1. As you might assume, near transfer is easier for people functioning typically. The simplicity of this discussion doesn’t do justice to this complex process. Actually, processing occurs on many levels simultaneously (Snyder, Dabasinskas, & O’Connor, 2002). At bottom levels, processing is shallow and involves primarily perceptual analysis. In contrast, top levels of processing are more elaborate and associate the new information with knowledge already storied in the brain. As you might surmise, top processing results in better memory because of the associations formed (Hamman & Squire, 1996, 1997). Less complex stimuli are initially processed via perceptual analysis at bottom levels then forwarded to working memory for more elaborate encoding—a process called bottom-up processing—and storage in long-term memory. For more elaborate stimuli, such as language, the brain activates higher, or top-level, processes, such as linguistic and word knowledge. Through these processes, the brain formulates “guesses” of what’s coming next, and the low-level processes analyze incoming information perceptually to see how it fits. This process is called top-down. In other words, language is “heard” in accordance with the guesses that are based on stored linguistic information and the message so far (Samuel, 2001). It’s unknown whether the two processes are dependent, interdependent, independent, or if they function simultaneously (Von Berger, Wulfeck, Bates, & Fink, 1996). In addition, the processes may operate either automatically or in a controlled fashion based on the amount and type of information incoming, the demands of the task, and the capacity of the individual. In contrast to automatic processes, controlled ones are performed consciously and intentionally and make considerable demands on the resources of the brain. It’s believed that working memory is the “place” where information is kept active through a system of coding, storage, access, and retrieval (Gillam & Bedore, 2000). Working memory is the place where information, such as an incoming or outgoing sentence, is held while it is processed. While encoding and decoding, working memory must have enough capacity to handle complex information but be flexible to keep up with changing input.

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The brain’s central executive function (CEF) determines the cognitive resources needed and monitors and evaluates their application while controlling the flow of information. Thus, the CEF is responsible for selective attention and for the coordination and inhibition of stimuli and concepts (Baddeley, 1996). Children with LI may exhibit difficulty with CEF in the ways in which they attend to and perceive information and the ways in which concepts are represented (Gillam, Hoffman, Marler, & WynnDancy, 2002). Now let’s pull this all together. And this is important. If a child must use controlled processes in bottom-level analyses, he or she may be limiting the amount of language processed. In other words, the child may not have the resources available for automatic top-level analysis (Ellis Weismer, 1994; Ellis Weismer & Hesketh, 1996; Johnston, 1995). Too much energy expended in bottom-level controlled analysis—because of poor attending, poor working memory, poor discrimination, or poor organization and/or retrieval—may limit the child’s ability to process language automatically at higher levels of functioning. As we discuss information processing in each disorder, remember the overall process and the effects that each step in the process has on the others. For a more detailed discussion see Owens (2008). M E NTAL R ETAR DATION OR I NTE LLECTUAL DISAB I LITY The American Association on Intellectual and Developmental Disabilities (AAIDD) defines intellectual disability (ID) as the following: limitations in intrllrctual functioning; • Substantial Significantly limitations in adaptive behavior consisting of conceptual, social, and practical skills; • and • Originating before age 18 (AAIDD, 2008) This definition needs some explanation. Significant limitations means two standard deviations below the mean of 100, a position at the extreme of the human intelligence curve. Approximately 3 percent of the population is below this point, which is at an IQ of 68. The definition is concerned with more than IQ, which is a measure of past learning, and considers intellectual functioning plus adaptive areas. Finally, individuals with mental retardation are considered to be developmental beings, so the definition covers the period during which humans develop into adults. Only individuals who meet all of the criteria are considered to have intellectual disabilities. The exact number of individuals who have intellectual disability is unknown. Estimates vary from 1 to 3 percent of the population, or approximately 3 to 9 million people in the United States. Severity varies among individuals and usually changes little over time. Severity typically is associated with IQ, as noted in Table 2.1. Nearly 90 percent of the population with ID is classified as mildly retarded. Not every child with ID is similar. Differences in severity occur, and other factors, such as amount of home support, living environment, education, type of retardation, mode of communication, and age, must be considered. I have worked with very social, very verbal preschoolers and with adolescents and adults with severe multiple disabilities and very few usable communication behaviors.

Chapter 2

TABLE 2.1 Severity

Language Impairments

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Severity of Intellectual Disability IQ Range

% of MR Characteristics

Mild

52–68

89.0

Usually live and work independently within the regular community. Often have families.

Moderate

36–51

6

Capable of some semi-independence at work and in residence. As adults, many work in supportive environments and live with relatives or in community residences.

Severe

20–35

3.5

Capable of learning some self-care skills and are not totally dependent. Some adults are able to work in a supportive environment and live with relatives or in community residences.

Profound

19 and below

1.5

Capable of learning some basic living skills but will require continual care and supervision. Often exhibit multiple handicaps.

Source: Adapted from American Association on Mental Retardation (1992).

Language Characteristics Language is often one of the most impaired areas for a child with ID and may be the single most important characteristic of the disorder. Even when compared with typically developing (TD) children of the same mental age, children with ID often exhibit poorer language skills. Although some of this language difference may be attributed to low intellectual functioning, this factor alone does not fully explain the phenomenon. In addition, the cognition–language relationship is an inconsistent one among individuals with ID. For approximately half of the population with ID, both language comprehension and production levels are similar to cognitive levels. In other words, a 6-year-old child with ID might have both a mental age and a language age of 42 months. In 25 percent of the population, both language comprehension and production are below the level of cognition. Finally, in another 25 percent, language comprehension and cognition are at similar levels but language production is below both. Differences between the language of children with ID and those developing typically are presented in Table 2.2. It cannot be stressed enough that children with ID vary greatly in their communication abilities. In general, children with Down syndrome (DS) and those with fragile X syndrome (FXS), both explained later, have moderate to severe delays in communication development in speech and in all areas of language (Roberts, Mirrett, & Burchinal, 2001). Some children with FXS also exhibit behaviors associated with autism spectrum disorder (ASD), discussed later in this chapter. These children tend to have more severe language impairment than those without ASD (Philofsky, Hepburn, Hayes, Hagerman, & Rogers, 2004). Boys with FXS perform differently in conversation than boys with Down syndrome. Although both groups make more noncontingent, or off-topic, responses than typically developing (TD) boys, those with FXS use more perseverative or overly repetitious speech (Roberts, Martin, Maskowitz, Harris, Foreman, et al., 2007). In phonology, boys with FXS make errors similar to those of younger typically developing youth, while those with Down syndrome have more significant phonological differences than might be expected by delayed development alone (Roberts, Long, Malkin, Barnes, Skinner, et al., 2005). Prior to a mental age of 10, the overall sequence of development of children with ID is similar to that of TD children, but the rate is slower (Pruess, Vadasy, & Fewell, 1987). This pattern can be seen in

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TABLE 2.2

Language Characteristics of Children with Intellectual Disability

Pragmatics

Gestural and intentional developmental patterns similar to those of children developing normally. Delayed gestural requesting. May take less dominant conversational role. No difference in clarification skills from mental-age-matched peers developing typically.

Semantics

More concrete word meanings. Slow vocabulary growth. More limited use of a variety of semantic units. Children with Down syndrome able to learn word meanings from exposure in context as well as mental-age-matched peers developing typically.

Syntax/Morphology

Length-complexity relationship similar to that of preschoolers developing typically. Same sequence of general sentence development as children developing typically. Shorter, less complex sentences with fewer subject elaborations or relative clauses than mental-age-matched peers developing typically. Sentence word order takes precedence over word relationships. Reliance on less mature forms, though capable of more advanced. Same order of morpheme development as preschoolers developing typically.

Phonology

Phonological rules similar to those of preschoolers developing typically but reliance on less mature forms, though capable of more advanced ones.

Comprehension

Poorer receptive language skills, especially children with Down syndrome, than mental-age-matched peers developing typically. Poorer sentence recall than mental-age-matched peers. More reliance on context to extract meaning.

Source: Based on Abbeduto, Davies, Solesby, & Furman (1991); Abbeduto, Short-Meyerson, Benson, & Dolish (1997); Chapman, Kay-Raining Bird, & Schwartz (1990); Chapman, Schwartz, & Kay-Raining Bird (1988); Kernan (1990); Klink, Gerstman, Raphael, Schlanger, & Newsome (1986); Merrill & Bilsky (1990); Mervis (1988); Moran, Money, & Leonard (1984); Mundy, Kasari, Sigman, & Ruskin (1995); Owens & MacDonald (1982); Rondal, Ghiotto, Bredart, & Bachelet (1988); Rosin, Swift, Bless, & Vetter (1988); Shriberg & Widder (1990).

development of intentions, role taking, presupposition, sentence forms, morphological markers, and phonological processes (Mundy, Kasari, Sigman, & Ruskin, 1995; Owens & MacDonald, 1982; Shriberg & Widder, 1990). Presupposition is the speaker’s assumption of the listener’s perspective, what she or he knows and needs to know. This said, children with Down syndrome, a chromosomal disorder, are also as skilled as their mental-age-matched TD peers in inferring novel word meanings and in producing these words correctly thereafter (Chapman, Kay-Raining Bird, & Schwartz, 1990). Even when children are matched for mental age, however, children with ID seem to use more immature forms than do their TD peers. The utterances of children with MR tend to be shorter and less complex. Although the narratives of children and adults with Down syndrome are of the same length and complexity as those of mental-age-matched TD peers, the linguistic devices and cohesion are poorer (Boudreau & Chapman, 2000). Children with DS produce fewer words, fewer different words, and shorter utterances while engaging in more verbal perseveration than mental-age-matched

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TD peers (Rein & Kernan, 1989). Perseveration is excessive talking on a topic when it is inappropriate or needless repetition. Males with FXS perseverate more than children with Down syndrome and exhibit more jargon, or meaningless unintelligible speech, and more echolalia, or repetition of a partner’s speech. Although children with ID are capable of learning syntactic rules, they tend to rely on less mature word-order rules and a less mature and simpler method of interpretation. Likewise, although capable of requesting clarification when communication breaks down, children with ID are less likely to do so within conversations (Abbeduto, Davies, Solesby, & Furman, 1991). It is possible that the difficulties noted in the language of children with ID reflect problems integrating learning into ongoing events. Possibly these children are using much of their available cognitive energy to monitor and understand the conversation, leaving little for integration of language skills. All of us experience this phenomenon with newly acquired skills until they become more automatic. Finally, some children with ID, especially those with DS, exhibit poorer receptive language skills than do their mental-age-matched TD peers (Abbeduto, Furman, & Davies, 1989; Chapman, Schwartz, & Kay-Raining Bird, 1988; Mervis, 1988; Rosin Swift, Bless, & Vetter, 1988). The context seems particularly important for these children in aiding comprehension (Ezell & Goldstein, 1991). Possible Causal Factors Possible causal factors for ID are many and varied, including, but not limited to, biological and socialenvironmental causes of retardation and information-processing differences related to language comprehension and production (Table 2.3). Any discussion of causality must be tempered with the recognition that for many children the cause of mental retardation is unknown. In addition, more than one causal factor may be at work. In any case, causal factors rarely are related directly to the performance level of the child in question. Biological Factors Biological causes are most likely a factor for a majority of children with ID. These include genetic and chromosomal causes, such as Down syndrome (DS); maternal infections, such as rubella or measles; toxins and chemical agents, causing, for example, fetal alcohol syndrome; nutritional and metabolic causes, such as phenylketonuria, or PKU; gestational disorders, primarily in the formation of the brain or skull; complications from pregnancy and delivery; and gross brain diseases, including tumors. In general, a strong correlation exists between biological factors and severity of retardation. Remember that although biological causal factors may explain resultant retardation in part, they tell us very little about development, specifically language acquisition. Social-Environmental Factors Social-environmental causal factors of retardation are more difficult to identify and may involve many interactive variables. Deprivation, poor housing and diet, poor hygiene, and lack of medical care can affect the development of the child adversely, although the exact effect of each is unknown and varies with each child. Despite the fact that children with ID display only limited behaviors, there is no evidence that their mothers interact with them less. In general, maternal behavior varies with the child’s language level, whether the child has ID or is developing typically. Mothers of children with ID do talk more to their children. By attributing more meaning to their children’s less frequent behaviors, these mothers are able to interact more frequently (Yoder & Feagans, 1988). In short, mothers of children with ID interpret more of their children’s behaviors as communicative than do mothers of children developing typically.

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TABLE 2.3

Causal Factors Related to Intellectual Disability (Adapted from AAMR)

Type

Biologic Genetic and chromosomal

Examples

Characteristics

Down syndrome (Trisomy 21) Fragile X syndrome

Broad head and characteristic facial features, small stature, mental retardation Mental retardation in males, possible learning disabilities in females; 4:1 males to females Catlike cry, microcephaly, mental retardation

Cri-du-chat syndrome Infectious processes

Maternal rubella Congenital syphilis

Toxins and chemical agents

Fetal alcohol syndrome Lead poisoning

Nutrition and metabolism

Phenylketonuria (PKU) Tay-Sachs disease Inadequate diet

Gestational disorders

Hydrocephalus

Cardiac defects, cataracts, hearing loss, microcephaly, possible mental retardation Deafness, vision problems, possible epilepsy or cerebral palsy, mental retardation Persistently deficient growth, low brain weight, facial abnormalities, cardiac defects, mental retardation Central nervous system and kidney damage, hyperactivity Reduced pigmentation, motor coordination problems, convulsions, microcephaly, mental retardation Progressive deterioration of nervous system and vision, mental retardation, death in preschool years Small stature, possible mental retardation

Craniofacial anomalies

Enlarged head caused by increased volume of cerebralspinal fluid, visual defects, epilepsy, mental retardation Absence or underdevelopment of cerebral cortex and resultant mental retardation Malformed skull and associated mental retardation

Complications of pregnancy and delivery

Extreme immaturity or preterm infant Exceptionally large baby Maternal nutritional disorders

Low birth weight, higher prevalence of central nervous system disorders Possible birth injury to central nervous system Low birth weight, higher prevalence of central nervous system disorders

Gross brain diseases

Tumors and tuberous sclerosis Huntington disease

Tumors in heart, seizures, tuberous “bumps” on nose and cheeks, mental retardation Degenerative neurological functioning evidenced in progressive dementia and cerebral palsy

Cerebral malformation

Social-Environmental Psychosocial disadvantage

Sensory deprivation

Subnormal intellectual Functional retardation functioning in immediate family and/or impoverished environment Maternal deprivation Functional retardation and failure to thrive Prolonged isolation

Source: Owens (1997). Mental retardation. In D. Bernstein & E. Tiegerman-Farber, Language and communication disorders in children (4th ed.). Boston: Allyn & Bacon. Reprinted by permission.

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Mothers of children with ID match their verbal behavior to their child’s language ability while adopting a teaching role (Davis, Stroud, & Green, 1988). Although they exert more control in play than do mothers of children developing typically, mothers of children with DS are equally or more responsive to their children (Tannock, 1988a, 1988b). Their control behavior includes trying to elicit more responses from their children. Processing Factors There may be differences in the cognitive, or information-processing, abilities of the ID population that cannot be attributed to low IQ alone. Children with ID do not seem to process information in the same manner as mental-age-matched TD peers. This difference is especially critical for learning. Cognitive abilities important for learning are attention, discrimination, organization, memory, and transfer. Attention. In general, individuals with ID can sustain attention as well as mental-age-matched TD peers. Difficulty comes for the individual with ID in the scanning and selection of stimuli to which to attend. Persons with severe or profound ID have more limited attentional capacity and are less efficient at attention allocation (Nugent & Mosley, 1987). Discrimination. Individuals with ID have difficulty identifying relevant stimulus cues. This difficulty reflects, in part, the tendency of individuals with ID to attend to fewer dimensions of a task than do TD individuals. If the stimulus dimensions chosen are not the salient or important ones, the individual’s ability to discriminate and to compare new information to stored information is limited. Discrimination can be taught, however, and individuals with ID can apply this information to discrimination tasks as well as can individuals who are nonretarded. In general, discrimination ability and speed are related to severity of ID. The more severe the retardation, the slower and less accurate the discrimination. Organization. Individuals with mild-moderate ID have difficulty developing organizational strategies to aid storage and retrieval. They do not seem to rely on either mediational or associative strategies or to use them as efficiently as individuals developing typically. In mediational strategies, a word or a symbol, such as a category name, forms a link between two entities. In associative strategies, one word or symbol aids in recall of another, as in “bacon and _____” or “salt and _____.” Individuals with mild ID exhibit both simultaneous and successive coding; however, these individuals may use these processes differently from individuals who are nonretarded, especially in complex tasks. Individuals with Down syndrome seem to have greater difficulty with successive processing than do other mental-age-matched individuals with ID. This deficit may be explained in part by the poor verbal auditory working memory abilities of individuals with DS. It is interesting to note, however, that the reported sequential processing difficulties of children with DS do not affect number sequential recall (Kay-Raining Bird & Chapman, 1994). The element of meaning present in language may complicate verbal sequential processing. Memory. In general, individuals with ID demonstrate poorer recall than individuals developing typically. The more severe the retardation, the poorer the memory skills. Individuals with mildmoderate ID are able to retain information within long-term memory as well as TD individuals, but the retrieval process is slower (Merrill, 1985). No doubt, organizational deficits contribute to difficulty retrieving information. More obvious differences can be seen in short-term memory (Gutowski & Chechile, 1987). Poor performance by individuals with mild ID may reflect a limited use of associational strategies and

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organizational/storage deficits. It may be affected also by the rapid rate of forgetting, especially within the first 10 seconds, found in the population with ID (N. Ellis, Deacon, & Wooldridge, 1985). Information is retained by rehearsal. It appears that individuals with ID do not spontaneously rehearse and that they need more time than TD individuals to do so (Turner & Bray, 1985). The need for repeated input and practice retrieval are supported in studies of vocabulary learning among children with Down syndrome (Chapman, Sindberg, Bridge, Gigstead, & Hasketh, 2006). Memory can be affected also by the type of information. Individuals with ID do more poorly with auditory information than with visual (N. Ellis, Woodley-Zanthos, & Dulaney, 1989). Within auditory information, nonlinguistic signals, such as a car horn or a doorbell, are much easier for individuals with ID to remember than linguistic information. In general, nonlinguistic signals can be recognized and recalled similarly by individuals with mild ID and without. It is in the recall of linguistic information that differences become evident. Sentence recall involves reproduction from memory and editing of the recalled text. For individuals with mild ID, difficulty probably is encountered in the second stage. Auditory memory deficits are exhibited more by individuals with DS than by those with other types of retardation (Marcell & Weeks, 1988). Deficits in auditory short-term memory for words is implicated in the poor performance of children with DS in sentence memory tasks (Miolo, Chapman, & Sindberg, 2005). Phonological short-term recall seems to be especially affected (Seung & Chapman, 2000). This difficulty may be related to poor verbal working memory, a process that enables the hearer to continue to hear a sound after it has ceased. The “echo” may decay more rapidly among individuals with DS than among individuals developing typically. The memory deficit among individuals with DS is specific to verbal information and seems unrelated to receptive vocabulary or auditory or speech difficulties (Jarrold, Baddeley, & Phillips, 2002). Transfer. Transfer, or generalization, is an area of processing especially difficult for individuals with ID. Although learning may enhance performance, it does not enhance generalization. In general, the more severe a person’s ID, the weaker that person’s transfer abilities. In addition, persons with ID have difficulty with both near and far transfer, in part because of an inability to detect similarities. Thus, generalization deficits may reflect discrimination and organization problems mentioned previously.

Conclusion Generalizations about the language skills of the population with ID are complicated by the many causes of ID and by different severities. Overall, language development follows a path similar to typical development but at a slower pace. Still, differences occur, such as the reliance on less mature forms and the overuse of others. These differences may reflect the information-processing difference found in individuals with ID, especially in the areas of organization and memory. Problems in information processing help us understand ID and other disorders but do not explain these disorders. Differences may represent the cause, the result, or a concurrent problem (Leonard, 1987). In any case, the differences found in the population with ID suggest certain intervention techniques to be used when working with children with ID. These are represented in Table 2.4. An SLP must be mindful of individual learning styles as well as those of certain identifiable groups of children. For example, accommodations must be made in intervention for the special learning needs of boys with FXS. In short, with these boys, an SLP can take advantage of their more visual learning style while stressing listening and comprehension. Intervention sessions must accommodate to these

Chapter 2

TABLE 2.4

Language Impairments

33

Techniques to Use with Individuals with Intellectual Disability

Attention 1. Aid attending by visually or auditorily highlighting stimulus cues. Likewise, gestures used to highlight important information can enhance the auditory message. Cues should be gradually decreased. 2. Teach child to scan stimuli for relevant cues. Discrimination 1. Highlight and explain similarities and differences that will aid discrimination. Preschoolers do not understand terms such as same and different. Teachers must demonstrate likenesses and differences, such as hair/no-hair. Meaningful sorting tasks with real objects can be helpful. Overall size and shape (not circle, square, or triangle) and function are relevant characteristics for preschoolers. Organization 1. “Pre-organize” information for easier processing and storage. No “winging it” here. Visual and spatial cues may be helpful. 2. Train associate strategies. What things go together? Why? 3. Use short-term memory tasks, such as repetition of important information, to aid simultaneous and successive processing. Repetition and interpretation are helpful. Memory 1. Train rehearsal strategies, such as physical imitation. Gradually shift to more symbolic rehearsal tasks. 2. Use overlearning and lots of examples. 3. Train both signal (sounds, smells, tastes, sights) and symbol recall of events. Signals, which are easier to recall, can be gradually reduced. 4. Word associations for new words will improve recall of the words. Likewise sentential and narrative associations will improve recall. 5. Highlight important information to be remembered, thus enhancing selective attending. 6. Use visual memory to enhance auditory memory. Transfer 1. Training situations should be very similar or identical to the generalization context. Use real items in training, at least initially. 2. Highlight similarities between situations, especially if training and generalization contexts differ. Help child recall similarities. 3. Help child recall previous tasks when approaching new problems. 4. Use people in child’s everyday contexts for training. Source: Adapted from Owens (1989).

boys’ short attention span, difficulty with transitions to new activities or topics, other sensory deficits, and low tolerance of stress (Mirrett, Roberts, & Price, 2003). Some of these children have nonverbal learning disability (NLD), which is characterized by deficits in visual and tactile perception, psychomotor skills, and learning novel information. Although language form is relatively unaffected in children with NLD, subtle pragmatic and semantic impairments exist.

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LANG UAG E LEAR N I NG DISAB I LITY The National Joint Committee on Learning Disabilities (1991) has adopted the following definition of learning disabilities: Learning disability is a general term that refers to a heterogeneous group of disorders manifested by significant difficulties in the acquisition and use of listening, speaking, reading, writing, reasoning, or mathematical abilities. These disorders are intrinsic to the individual, presumed to be due to central nervous system dysfunction, and may occur across the lifespan. Problems in selfregulatory behaviors, social perception, and social interaction may exist with learning disabilities but do not by themselves constitute a learning disability. Although learning disabilities may occur concomitantly with other handicapping conditions . . . or with extrinsic influences . . . , they are not the result of those conditions or influences. (p. 19) Let’s explore this wordy definition a bit. First, as with other disorders, learning disability (LD) is characterized by heterogeneity. It is also important to note that the cause is presumed to be central nervous system dysfunction, although other conditions also may be present. Thus, the cause of learning difficulties is not environmental, nor is it these other accompanying conditions. Although not stated, it is assumed that children with LD have normal or near-normal intelligence. Most children with learning disabilities will not have all of the characteristics. For example, approximately 15 percent have difficulty with motor learning and coordination. More than 75 percent have difficulty learning and using symbols (Miniutti, 1991). These children are considered by some to have a language learning disability (LLD). The characteristics of children with LD are many and varied. In general, they divide into six categories: motor, attention, perception, symbol, memory, and emotion. Let’s discuss each. Symbol difficulties are discussed under language characteristics. Motor difficulties usually involve hyperactivity, a condition of overactivity in which children seem to be constantly in motion. Approximately 5 percent of all children have hyperactivity, but the condition is nine times as prevalent in boys as in girls (Sattler, 1988). Not all children with hyperactivity have learning disabilities, nor do all children with LD have hyperactivity. The condition is difficult to assess, especially among preschoolers, in part because of the wide range of variability (S. Campbell, 1985). Children with hyperactivity have difficulty attending and concentrating for more than very short periods of time. Other motor difficulties of LD may include poor sense of body movement, poorly defined handedness, poor hand-eye coordination, and poorly defined concepts of space and time. Attentional difficulties include a short attention span and inattentiveness. Children with LD seem easily distracted by irrelevant stimuli and easily overstimulated. At present, we are in the middle of an identification frenzy regarding children and adults and their ability to learn and organize their lives. More and more individuals are being labeled with attention deficit hyperactivity disorder, or ADHD, characterized by overactivity and an inability to attend for more than a very short period but without many of the associated difficulties of learning disability. ADHD is most likely an impairment in the executive function of the brain that regulates behavior, especially impulsivity. Although these children have difficulty using language for social and educational purposes, their language deficits are difficult to measure with standardized testing (Oram, Fine, Okamoto, & Tannock, 1999). Although this explosion of identification of kids and adults with ADHD reflects some real differences, it also reflects our rigid one-

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size-fits-all educational system (Wallach & Butler, 1995), sedentary lifestyle, addiction to junk food, and hectic, overworked parents and teachers. Some children with learning disabilities may become fixed on a single task or behavior and repeat it. This fixation, mentioned previously, is called perseveration. Several children with whom I have worked would repeat an utterance over and over, seemingly unaware that they were doing it. Perception and reception are not the same. Learning disability is not a sensory or reception disorder. Perceptual difficulties are interpretational difficulties. These occur after the stimuli are received. As might be assumed, children with learning disabilities may confuse similar sounds and words and similar printed letters and words. In addition, these children may have difficulty in figure-ground perception and in sensory integration. Figure-ground perception involves being able to isolate a stimulus against a background of competing stimuli. For example, figure-ground discrimination would include being able to listen to the teacher while other things are occurring in the classroom. Sensory integration, on the other hand, involves being able to make sense of visual and auditory stimuli occurring at the same time. Each may carry part of the message. For example, gestures, facial expression, body language, intonation, and verbal language may be used to convey information. Each alone may be insufficient. Memory difficulties include short-term and long-term storage and retrieval. Children with LD often have difficulty remembering directions, names, and sequences. Word-finding problems are also common. Finally, emotional problems also may accompany LD but are not a causal factor. Rather, emotional problems are a reaction to or an accompaniment to the frustrating situation in which these children find themselves. Children with LD have been described as aggressive, impulsive, unpredictable, withdrawn, and impatient. Some children may exercise poor judgment, have unusual fears, and/or adjust poorly to change. I worked with a child with learning disabilities who was afraid of shoes, a rather unusual fear. In others, poor adjustment to change may reflect dependence on routines when one has difficulty interpreting language in those contexts. Language Characteristics Usually all aspects of language, spoken and written, are affected to some extent in children with learning disabilities (Wallach & Butler, 1995). It should be stressed again that although these children may play the TV or radio at a loud volume, or seem to talk too loudly, or squint and rub their eyes when reading, the problem is not sensory. Although hearing or vision difficulties may or may not be present, they are not central to the disorder. Difficulties are perceptual. Children with LD may have difficulty with the give-and-take of conversation and with the form and content of language (Table 2.5). Synthesizing of language rules seems to be particularly difficult, resulting in delays in morphological rule acquisition and in the development of syntactic complexity. Problems with morphological markers are found both in speaking and writing, with the most common error being omission (Windsor, Scott, & Street, 2000). Overall oral language development for children with LD may be slow (Reed, 1986). Their language is often like that of younger children, although children with LD may use mature structures less frequently. As preschoolers, these children may exhibit little interest in language and may be unable to follow a story or be disinterested in books. Word finding is a particular problem found in both conversations and narratives (German, 1987), resulting in greater time needed to respond verbally. Retrieval difficulties may result in more

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TABLE 2.5

Language Characteristics of Children with Learning Disability

Pragmatics

Little problem with turn taking. Difficulty answering questions or requesting clarification. Difficulty initiating or maintaining a conversation.

Semantics

Relational term difficulty (comparative, spatial, temporal). Figurative language and dual definition problems. Word-finding and definitional problems. Conjunction (and, but, so, because, etc.) confusion.

Syntax/Morphology

Difficulty with negative and passive constructions, relative clauses, contractions, and adjectival forms. Difficulty with verb tense markers, possession, and pronouns. Able to repeat sentences but often in reduced form, indicating difficulty learning different sentence forms. Article (a, an, the) confusion.

Phonology

Inconsistent sound production, especially as complexity increases.

Comprehension

Wh- question confusion. Receptive vocabulary similar to that of chronological-age-matched peers developing normally. Poor strategies for-interacting with printed information. Confusion of letters that look similar and words that sound similar.

Source: Based on Baker, Ceci, & Hermann (1987); Catts (1986); Kail & Leonard (1986); Lieberman, Meskill, Chatillon, & Schupack (1985); Seidenberg & Bernstein (1986); Wiig & Wilson (1994).

communication breakdown (MacLachlan & Chapman, 1988), characterized by repetitions, especially of pronouns before words seemingly difficult to retrieve (“He, he, he . . . John was . . .”), reformulations, substitutions of indefinite pronouns (it), empty words (one, thing), delays, and insertions (“He was . . . oh, I can’t remember . . .”) (German & Simon, 1991). Word-retrieval difficulties may be complicated by the deficient vocabularies of children with LD (Leonard, 1990; Wiig, 1990). Young children with LD have poor understanding of literal meanings. As these children age, they experience difficulties with multiple and figurative meanings (R. Lee & Kamhi, 1990; Lutzer, 1988; Seidenberg & Bernstein, 1986; Wiig, 1990). The linguistic demands of the classroom are often well above the oral language abilities of these children. The well-documented academic underachievement of children with LD demonstrates the link between language deficits and learning disabilities (Catts & Kamhi, 1986). Oral language skills are the single best indicator of reading and writing success in school. Difficulty with oral language skills among children with LD is evidenced later in written-language problems, called dyslexia. Dyslexia is a specific learning disability characterized by difficulties in fluent and/or accurate word recognition and in spelling most often associated with phonological awareness or sensitivity to and awareness of the sound and syllable structure of words (Lyon, Shaywitz, & Shaywitz, 2003). Oral language difficulties are also present (Gallagher, Frith, & Snowling, 2000). It’s estimated that possibly as many as 80 percent of children with LD have some form of reading problem and that the incidence of dyslexia in the overall population many range from 5 to 17 percent, depending on how the term is defined (Sawyer, 2006). In either case, a significant portion of the population may exhibit some dyslexic

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characteristics. The disorder is found among males at twice the rate as females. Although there’s no generally agreed-upon definition, when we compare children with dyslexia to their TD peers, some common elements appear (Sawyer, 2006): verbal IQ and/or listening comprehension • Comparable Below average word reading • Nonsense or non-real word reading (word attack) below real-word reading • Well below average phonological processing scores • Three distinct types of dyslexia have been described, including a language-based disorder that may affect comprehension and/or speech sound discrimination, a speech/motor disorder that may affect speech sound blending and motor coordination although receptive language is unaffected, and a visuospatial disorder that may affect letter-form discrimination although language is relatively unaffected. The language-based disorder is the most common. Although reading and writing are different, certain underlying processes influence both. For example, often there is no overall organization to the writing of children with LD. In reading, they also fail to understand the underlying organization, thus treating each sentence as separate and unrelated to the whole (Raphael & Englert, 1990; Seidenberg, 1989). The behavior of children with LD also demonstrates the interrelatedness of cognition and language. This relationship can be seen in analogical reasoning skills in which known concepts are used to solve novel problems. In verbal proposition (A is to B as C is to _____), one type of analogical reasoning, language abilities appear to be more important than, but not exclusive of, cognitive abilities (Masterson, Evans, & Aloia, 1993). Children with LD demonstrate difficulty with verbal analogies such as these (Kamhi, Gentry, Mauer, & Gholson, 1990; Nippold, Erskine, & Freed, 1988). Some of the blame for the problems of children with dyslexia must go to English itself. The rate of dyslexia is twice as high in English-speaking countries as in those with less complex languages. Italian and Spanish, for example, have a more one-to-one relationship between letters, or graphemes, and sounds, or phonemes. In English there are over 1,100 ways to combine the graphemes to represent the phonemes. Possible Causal Factors Several causal factors may contribute to LD. Central nervous system dysfunction indicates a strong biological basis, but information processing, especially perception, is also important. Biological Factors Learning disabilities occur more frequently in families with a history of the disorder and following premature or difficult birth. Children with a parent with dyslexia, especially those with a history of late talking, are at a higher risk for language impairment (Lyytinen, Poikkeus, Laakso, Eklund, & Lyytinen, 2001). These facts, along with central nervous system dysfunction, demonstrate a biological link to the disorder. In addition, the use of neurostimulants, such as Ritalin, to enable some children with hyperactivity to concentrate and attend further suggests a biological basis. It has been suggested that a breakdown occurs along the neural pathways that connect the midbrain with the frontal cortex. This is the area of the brain responsible for attention, regulation, and planning (Bass, 1988). These biological factors alone are insufficient to explain the characteristics that accompany learning disability.

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Several studies have attempted to find a biological cause for dyslexia. It is doubtful that there is a single dyslexia gene. More likely is a scenario in which possibly as many as seven chromosomes are involved in various aspects of the disorder (Grigorenko, 2005). Malformations found in the left hemisphere language-processing areas and between these areas and the visual cortex may be related to these genetic changes and to language-processing deficits (summarized in Galaburda, 2005). MRI studies indicate that, when compared to TD children during reading, children with dyslexia exhibited lower activation of the left occipitotemporal region and heightened activation of Wernicke’s area and the frontal lobe areas associated with motor movement, suggesting compensatory use of these areas (Shaywitz & Shaywitz, 2003). Social-Environmental Factors Although our definition of learning disability precluded any environmental causality, certain environmental factors are important. The language and, in turn, interactional difficulties of children with LD certainly will influence a child’s development. Similarly, many of the acting-out behaviors of these children are in response to the very frustrating situations of their lives. Until the disorder is diagnosed, these children are accused of not trying or of being lazy or stupid. Many of the children with whom I have worked had extremely poor self-images. Many were afraid to try anything new; others would do anything for attention and recognition, even if such recognition was negative. The successes or failures that we have as we interact with others have a great influence on our future interactions. Processing Factors Children with LD do not appear to function in a manner appropriate for their intellectual level. They seem unable to use certain strategies or to access certain stored information. Children with LD exercise poor attentional selectivity, concentrating on inappropriate or unimportant stimuli (Levine, 1987). Appropriate and important information may be screened out along with other information. These children have difficulty deciding on the relevant information to which to attend in both oral and written communication. As mentioned previously, discrimination is extremely difficult for children with LD. A child has difficulty deciding on the relevant aspects of a stimulus that make it similar or dissimilar to another. Children with LD do more poorly than mental-age-matched to peers on rule extraction or identification from repeated exposures (Masterson, 1993). Poor discrimination skills may also reflect deficits in working memory (Harris Wright & Newhoff, 2001). Obviously, information that is poorly attended to and poorly discriminated will be poorly organized. These are children for whom the world often does not make sense, especially linguistically. Their storage categories reflect this confusion. Unlike children with ID, who do not organize spontaneously, children with LD do organize information but too inefficiently for later use. Memory is related to storage, or availability, and retrieval, or accessibility—distinct but related processes (Bjork & Bjork, 1992). Growth in word knowledge results in the creation of semantic networks in which words are related and organized. This growth occurs later and more slowly among children with LD (Leonard, 1990; Reed, 1986; Wiig, 1990). One result is less accurate and slower retrieval by children with LD (German, 1984; Wolf, Bally, & Morris, 1986). Effective learners actively process, interpret, and synthesize information by using effective strategies to monitor and organize learning. Children with LD often fail to access or use taskappropriate strategies spontaneously. These problems persist throughout adolescence and into adulthood. Strategies for working with children with LD based on their processing deficits are presented in Table 2.6.

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Techniques to Use with Children with LD

Attention 1. Reduce competing stimuli. Gradually reintroduce these stimuli as child becomes better able to tolerate them. Eventually intervention should move into the classroom with all the competing stimuli. 2. Highlight those aspects of a situation to which the child is to attend. 3. Use visual and physical cues to aid the child in attending to verbal ones. Perception 1. Train initially with nonspeech environmental sounds, then speech sounds. 2. Use visual and physical cues to aid the child in interpreting verbal ones. 3. Use meaning-based tasks in which a sound change changes the meaning. 4. Visual or hand signals may be used to aid intonational interpretation and turn taking. Organization 1. Help child to see underlying relationships. Use categorizational, associational, and word-class sorting tasks. Use “spreading” model so child realizes many possible associations. 2. Use same/different tasks and match to sample. 3. Be alert that the child’s associations may not be the same as adult ones. Try to understand the relationships that may have validity for the child. Memory and Generalization/Transfer 1. Practice serial recall, first visually (locomotive, touch), then auditorily. 2. Control for infrequent words, linguistic complexity, length, intonation, context, and semantic-logical relationship. 3. Use command following. Control for number of elements and steps. 4. Ask questions about things that happened immediately before. Next, ask questions about slightly distant events. Increase the time lapse. Finally, ask questions concerning what was just said. 5. Teach in the location where you want the feature to be recalled.

Similar Impairments: Prenatal Drug and Alcohol Exposure I have decided to place children with fetal alcohol spectrum disorder (FASD) and prenatal drug exposure in the learning disabilities section because of the similarities children with these disorders present in their behavior and in their language. No doubt there will be objections to this placement. When a pregnant woman drinks, the blood alcohol level of her fetus will be the same as her own. Maternal consumption of alcohol during pregnancy results in fetal alcohol spectrum disorder (FASD) for her baby. Disabilities associated with alcohol consumption during pregnancy are approximately 6 in every 1,000 live births (Health Resources and Services Administration [HRSA], 2005). FASD includes but is not limited to alcohol syndrome (FAS), which is characterized by developmental disorders, growth deficien• Fetal cies, and distinct facial characteristics

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neurodevelopmental disorder (ARND), which is characterized by significant • Alcohol-related impairments in several areas of development and distinct facial characteristics Exposure to alcohol in utero damages central nervous system development, leading to deficits in cognitive, behavioral, and socioemotional functioning (Streissguth & O’Malley, 2001). More specifically, these children will experience difficulties in attention, memory, executive function, learning, behavior control, mental health, and academics across their life spans. At birth, infants with FASD have a low birth weight and short length often accompanied by central nervous system dysfunction as evidenced in microcephaly or a small head, hyperactivity, motor problems, attention deficits, and cognitive disabilities. Mean IQs are in the borderline retarded category with a range of 30 to 105. In general, these children are concrete learners with poor problemsolving abilities and difficulty generalizing. They are easily distractable, easily overstimulated, impulsive, and perseverative; they have poor memory, interpersonal skills, and judgment; and they exhibit language problems characterized by delayed development, echolalia, and language production that exceeds comprehension. Intervention suggestions are presented in Table 2.7. As infants, children with FASD are irritable and have weak sucking and delayed development. Language deficits include problems with word order and word meaning and difficulties in the give-and-take of conversational discourse (Coggins, Olswang, Carmichael Olson, & Timler, 2003). Most often children with FASD are diagnosed as having a learning disability or ADHD. The socially competent communicator understands that communicators interact in predictable ways and uses executive function to direct the choice of language and nonverbal behaviors to fit the communication situation. These functions are disrupted in the child with FASD. Children with FASD are limited by the amount of linguistic information they can process and have deficits in concept formation, self-regulation, and response inhibition (Carmichael Olson, Feldman, Streissguth, Sampson, & Bookstein, 1998; Jacobson & Jacobson, 2000; Mattson, Goodman, Caine, Delsi, & Riley, 1999). Eleven to 35 percent of pregnant women ingest one or more illegal drugs. Although the percentages vary with race, ethnicity, age, socioeconomic status, and geographic location, the use of illegal drugs crosses all these boundaries. The effects on an infant vary with the amount and type of drugs, the method of ingestion, and the age of the fetus (C. C. MacDonald, 1992). Crack cocaine is especially destructive, with fetal death twice as common as among other noncocaine drug-dependent mothers and sudden infant death syndrome (SIDS) three times as high. Crack cocaine, a rapid-acting cerebrocortical stimulant, easily crosses the placental barrier, decreasing placental blood flow and fetal TABLE 2.7

Intervention Strategies for Children with Fetal Alcohol Syndrome

Remove erroneous stimulation. Provide preferential seating. Use picture cues to strengthen verbal instructions. Take care to describe and explain carefully and ask the child to repeat. Use eye contact or the child’s name prior to giving verbal instructions or directions. “Hook” the child’s attention with novel object, topics, and attention getters. Be patient. Challenge the child but remember that he or she may be easily frustrated. Set definite behavioral limits. Provide a tolerant and patient “buddy” to help the child with social interactions.

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oxygen supply, reaching significant blood levels in the fetus, and altering the fetus’s neurochemical functioning. Like infants with FAS, those exposed to crack cocaine also exhibit low birth weight and small head circumference; they are jittery and irritable and spend the majority of their time sleeping or crying. An infant may still be unable to reach an alert state by one month of age (Lesar, 1992). Infants exposed to drugs also have hypertonia, rapid respiration, and feeding difficulties (Weston, Ivins, Zuckerman, Jones, & Lopez, 1989). Easily overstimulated, these hypersensitive infants actively avoid the human face, which, because of its complexity, may overload them cognitively (Griffith, 1988). As might be expected, typical mother–child bonding is disrupted, with resultant delays in motor, social, and language development (Crites, Fischer, McNeish-Stengel, & Siegel, 1992). For her part, an addicted mother’s primary commitment is to drugs, and she may fail to attend to her child. A cycle of infant passivity and parental rejection may be established. The language characteristics of children exposed to drugs begin with few infant vocalizations, inappropriate use of gestures, and a lack of oral language. By preschool, these children are exhibiting word retrieval problems, short disorganized sentences, poor eye contact, turn-taking difficulties, few novel utterances, and inappropriate or off-topic responses (Mentis & Lundgren, 1995). In kindergarten, the child uses short, simple sentences and has a limited vocabulary, especially for abstract terms, multiple word meanings, and temporal/spatial terms. School-age years are characterized by problems with word retrieval and word order and by pragmatically inappropriate language (Rivers & Hedrick, 1992). Children with drug exposure are usually diagnosed as having a learning disability or ADHD. Conclusion LD is an extremely complex concept. Although it is relatively easy to describe the outward behaviors of children with LD, it is very difficult to explain the underlying processes. In short, biological or neurostructural differences and functional neuroprocessing differences in children with LD affect their ability to attend to, discriminate, and remember linguistic and other stimuli, resulting in language that may be impaired in all aspects and in all modes of transmission and reception. At this point, before I confuse you any more, it might be helpful for you to stop and jot a few notes contrasting intellectual disability with learning disability. As we proceed, you can add to your list. SPECI FIC LANG UAG E I M PAI R M E NT Specific language impairment (SLI) can be characterized as “significant limitations in language functioning that cannot be attributed to deficits in hearing, oral structure and function, or general intelligence” (Leonard, 1987, p. 1). In other words, this category of language impairment has no obvious cause and seems not to affect or be affected by anatomical, physical, or intellectual problems. Unlike some children with ID, but similar to most with LD, children with SLI exhibit language performance scores significantly lower than their intellectual performance scores on nonverbal tasks. Children with SLI do not exhibit the perceptual difficulties seen in LD nor the intellectual deficits of ID. SLI is characterized more by the exclusion of other disorders than on some readily identifiable trait or behavior (Leonard, 1991). Clinical identification is difficult and is usually based on the absence of other contributing factors. Even with a paucity of criteria for characterizing children with SLI, we can make certain definitive statements. Children with SLI may appear to be delayed in one aspect of language, although the language problem is not the result of delay, and children with SLI will not catch up to other children

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their age without intervention (Leonard, 1991). Even in their apparent delay, children with SLI are unlike children developing typically at any stage of development (Johnston, 1988b; Leonard, 1991). The usual criteria for SLI are a nonverbal or performance IQ above 85 and a low verbal IQ. For most, expressive abilities are significantly below receptive (Kamhi, 1998). Although children with SLI have typical nonverbal intelligence, they do exhibit deficits in a variety of nonverbal tasks, suggesting impaired or delayed cognitive functioning, such as manipulating mental images, hypothesis testing, haptic or touch recognition, and conservation, or knowing that quantity remains constant across changes unless quantity is added to or subtracted from (Mainela-Arnold, Evans, & Alibali, 2006). Conservation skills are closely related to language skills and verbal working memory for young schoolaged children. These same children have age-appropriate visuospatial short-term and working memory, a right hemisphere function (Archibald & Gathercole, 2006b). An auditory processing disorder in verbal working memory may be evident and will be discussed later (Friel-Patti, 1999; Montgomery, 2002b). As many as 10 to 15 percent of all children may be “late bloomers” who do not achieve fifty single words and two-word utterances by 24 months of age (Rescorla, 1989). Although most of these children seemingly “outgrow” their delay, approximately 20 to 50 percent have language problems that persist into preschool and school age (Paul, 1989a, 1996; Rescorla, 1990; Thal, 1989). These children form the core of those with SLI. As many as 7.4 percent of all kindergarten children may have SLI (Tomblin, Records, Buckwalter, Zhang, Smith, & O’Brien, 1997). Although SLI is a changeable condition with maturity, two-thirds of kindergartners with the impairment will still have difficulty with language as adolescents (Stothard, Snowling, Dishop, Chipchase, & Kaplan, 1998). For example, at age 14, children with SLI still exhibit slower response times in language tasks than do children developing typically (Miller, Leonard, Kail, Zhang, Tomblin, et al., 2006). Even those with more typical language had lingering problems with phonological problems and literacy skills. In general, children with SLI are perceived more negatively by both teachers and peers (Segebart DeThorne & Watkins, 2001). Young children may have behavior problems; however, these decrease with age (Redmond & Rice, 2002). In elementary school, children with SLI take minor roles in cooperative learning, contribute little, and have fewer high-level negotiating strategies than their language-abilitymatched peers developing typically (Brinton, Fujiki, & Higbee, 1998; Brinton, Fujiki, & McKee, 1998). By late elementary school or middle school, language problems take their toll on self-esteem, and these children perceive themselves negatively in scholastic competence, social acceptance, and behavior conduct (Jerome, Fujiki, Brinton, & James, 2002). Language Characteristics As with other language impairments, significant language differences are seen across children with SLI. The language impairment may be primarily, but not exclusively, expressive or receptive, or a combination of the two, and affect different aspects of language, although language form seems to be affected more than other aspects (Aram, 1991; N. Nelson, 1993). In addition, the disorder changes within an individual child as he or she matures. Language difficulties of children with SLI extend across early language skills important for reading decoding and comprehension (Boudreau & Hedberg, 1999). Errors seen in speech may also be present in writing (Gillam & Johnston, 1992). In general, children with SLI have difficulty (a) learning language rules, (b) registering different contexts for language, and (c) constructing word-referent associations for lexical growth (Connell & Stone, 1994; Ellis Weismer, 1991; Kiernan, Snow, Swisher, & Vance, 1997; Leonard, 1987). The result is

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difficulty in morphological and phonological rule learning and application and in vocabulary development (Bishop & Adams, 1992; Ellis Weismer, 1991; Rice, Buhr, & Oetting, 1992; van der Lely & Harris, 1990). Morphologic learning is more closely tied to overall language learning than other aspects of language (Dale & Cole, 1991). Pragmatic problems result from inability to use effective forms to accomplish language intentions. Specific language problems are listed in Table 2.8. TABLE 2.8

Language Characteristics of Children with Specific Language Impairment

Pragmatics

May act like younger children developing typically. Less flexibility in their language when tailoring the message to the listener or repairing communication breakdowns. Same pragmatic functions as chronological-age-matched peers developing typically, but expressed differently and less effectively. Less effective than chronological-age-matched peers in securing a conversational turn. Those with receptive difficulties most affected. Inappropriate responses to topic. Narratives less complete and more confusing than those of reading-abilitymatched peers developing typically.

Semantics

First words and subsequent vocabulary development occurs at a slower rate, with occasional lexical errors seen in younger children developing typically. Poor fast-mapping of novel words. Naming difficulties may reflect less rich and less elaborate semantic storage than actual retrieval difficulties. Long-term memory storage problems are probable.

Syntax/Morphology

Co-occurrence of more mature and less mature forms. Similar developmental order to that seen in children developing typically. Fewer morphemes, especially verb endings, auxiliary verbs, and function words (articles, prepositions) than younger MLU-matched peers. Learning related to grammatical function as in children developing typically. Tend to make pronoun errors, as do younger MLU-matched peers, but tend to overuse one form rather than making random errors.

Phonology

Phonological processes similar to those of younger children developing typically, but in different patterns, i.e., occurring in units of varying word length rather than in one- or two-word utterances. As toddlers, vocalize less and have less varied and less mature syllable structures than age-matched peers developing typically. Poor nonword repetition.

Comprehension

Poor discrimination of units of short duration (bound morphemes). Ineffective sentence comprehension. Reading miscues often unrelated to text graphophonemically, syntactically, semantically, or pragmatically.

Source: Based on Beastrom & Rice (1986); Bliss (1989); Brinton, Fujiki, Winkler, & Loeb (1986); Craig & Evans (1993); Craig & Washington (1993); Ellis Weismer & Hasketh (1996); Ellis Weismer et al. (2000); Gillam & Carlile (1997); Kail & Leonard (1986); Leonard (1986, 1989); Leonard, McGregor, & Allen (1992); Liles (1985a, b); Loeb & Leonard (1988); Merritt & Liles (1987); Montgomery (2000a, b); Newman & McGregor (2006); Rescorla & Ratner (1996); Rice & Oetting (1993); Rice, Oetting, Marquis, Bode, & Pae (1994); Rice & Wexler (1996); Watkins & Rice (1989).

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As might be expected, given the auditory processing problems of children with SLI, morphological inflections are especially difficult (Dale & Cole, 1991; Leonard, McGregor, & Allen, 1992). Morphemes are small units of language that receive little stress in speech. Verb endings and auxiliary verbs pose a particular problem, as does use of pronouns (Frome Loeb & Leonard, 1991; Oetting & Morohov, 1997). The two problems are related because pronoun selection (he versus they) determines some verb endings (walks versus walk) (Connell, 1986a). Verb morphology is a particular difficulty for young children with SLI. Auxiliary verbs, infinitives, verb endings, and irregular verbs offer persistent problems for both preschool and school-age children (Goffman & Leonard, 2000; Redmond & Rice, 2001). Although most tense markers are mastered at age 4 for children developing typically, children with SLI take an additional three years to achieve the same level of competence (Rice, Wexler, & Hershberger, 1998). Morpheme use is not a simple case of all or none. Children with SLI use the regular past tense –ed less when temporal adverbs, such as tomorrow and already, are present in the sentence, suggesting that other sentence elements also play a part in use of the tense marker (Krantz & Leonard, 2007). The relatively late appearance of tense markers, such as part tense –ed, may be an early indication of SLI (Hadley & Short, 2005). Morphological problems found in English have also been reported for children with SLI learning Spanish and modern Hebrew as a native language (Bedore & Leonard, 2001; Dromi, Leonard, Adam, & Zadunaisky-Ehrlich, 1999). The conversational behaviors of children with SLI compared with those of mental-age-matched peers developing typically are marked by both qualitative and quantitative differences (Craig, 1993). Qualitative differences, such as difficulty initiating interaction and inappropriate responses, lead to increased interruptions by other children and other quantitative changes. The child with SLI is less likely to interact with other children over time as the child experiences repeated failure. As a result, children with SLI often are ignored by other children in the classroom and experience reduced interactional opportunities. Thus, children with SLI have poorer social skills and fewer peer relationships and report less satisfaction with these relationships than age-matched classmates (Fujiki, Brinton, & Todd, 1996). In short, children with SLI have deficits in their ability to recognize the impact of and to express emotions when compared to typically developing age-matched peers (Brinton, Spackman, Fujiki, & Ricks, 2007). Both semantic and phonological deficits contribute to word-learning difficulties in children with SLI (Gray, 2004). For example, compared to their TD peers, children with SLI recognize fewer semantic aspects of objects and actions, such as physical features (color, shape, size), thematic elements (throw, hit, catch within a game), and/or causation (who caused an action, who or what received) (Alt, Plante, & Creusere, 2004). Language comprehension and processing are active processes in which the listener infers the meaning from the auditory message, contextual information, and stored world and word knowledge. Children with SLI do not appear to employ actively all of this available information. In general, they have difficulty constructing an integrated representation of a series of events, whether the series is presented verbally or nonverbally (Bishop & Adams, 1992). Thus, vocabulary growth—which occurs typically as the result of inferring meaning from repeated exposure and without direct reference or prompting from adults—will be very difficult for the child with SLI using limited active processing strategies (Rice, Buhr, & Nemeth, 1990; Rice et al., 1992; Weismer & Hesketh, 1996). Compared to TD school-age children, those with SLI, especially those with expressive language deficits, are less successful at initiating play interactions and engage in more individual play and onlooking behaviors (Liiva & Cleave, 2005). Teachers of children with SLI rate their students as exhibiting more

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reticence and solitary-passive withdrawal (Hart, Fujiki, Brinton, & Hart 2004). Reticence is characterized by staring at other children but not reacting, doing nothing even when there are many opportunities, and demonstrating fear of approaching other children. Children exhibiting solitary-passive withdrawal seem to enjoy solitude. Although they play with toys and engage in constructive activity, they do so alone. Reticence and extreme aloneness may lead to rejection by others in middle and high school (Rubin, Burgess, & Coplan, 2002). Children with SLI who have poor social skills are three times as likely to be victimized as their TD peers (Conti-Ramsden & Botting, 2004). In short, poor pragmatic skills are related to poor social outcomes. As a result, by the time they get to junior high, many adolescents with SLI perceive themselves negatively in scholastic competence, social acceptance, and behavioral conduct, characterized by choosing to act in the accepted manner (Jerome et al., 2002). Possible Causal Factors Causes of SLI are difficult to determine and may be as diverse as the children who have the impairment (Johnston, 1991; Tomblin, 1991). With such a diverse population, it is not surprising that several possible causal factors have been identified. Biological Factors The language and learning problems of children with SLI suggest a neurological disorder (Aram & Eisele, 1994). Possible neurological factors include brain asymmetry, in which language functions are located in different areas from those found in the majority of individuals, and delayed myelination, the progressive process of nerve sheathing that results in more rapid transmission of impulses (Galaburda, 1989; Hynd, Marshall, & Gonzalez, 1991; Love & Webb, 1986). The reported adeptness of children with SLI in analyzing visual, spatial patterns is considered by some to be evidence of greater reliance on the right hemisphere of the brain. Language processing, at least linear or sequential processing, is concentrated in the left temporal lobe. Magnetic resonance imaging (MRI) suggests that, compared to TD children, those with SLI exhibit different patterns of brain region activation and coordination that suggest reliance on a less functionally efficient pattern (Ellis Weismer, Plante, Jones, & Tomblin, 2005). These patterns are presented in Figure 2.2. The arrows in this schematic are sized to represent the amount of coordination between brain areas. Note the differences. In addition, those with SLI show reduced activation in the brain areas critical for communication processing (Hugdahl, Gundersen, Brekke, Thomsen, Rimol, et al., 2004). A biological cause is also suggested by a strong familial pattern (Choudhury & Benasich, 2003). Sixty percent of children with SLI have an affected family member, 38 percent an affected parent. The relationship is particularly strong for children with SLI who exhibit expressive language problems (Lahey & Edwards, 1995). When LI occurs in families with a history of SLI, it is often accompanied by reading impairments (Flax, Realpe-Bonilla, Hirsch, Brzustowicz, Bartlett, et al., 2003). Further evidence of a biological factor can be found in preterm births. A sizable minority of infants born at 32 weeks or less are at considerable risk for SLI (Briscoe, Gathercole, & Marlow, 1998). Social-Environmental Factors Although no one has suggested environmental causes, some differences do exist in the interactions of parents with children with SLI and those developing typically (Conti-Ramsden, 1990; Conti-Ramsden, Hutcheson, & Grove, 1995; K. Nelson, Welsh, Camarata, Butkovsky, & Camarata, 1995). Studies have reported conflicting data on the frequency of recast sentences by parents of children with SLI. Sentence recasts, such as expansions, are adult remixes or modifications in a child’s utterance that maintain the focus of the original utterance and can be an effective

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language teaching technique. For example, an adult could expand “Puppy bite” to “Yes, some puppies bite” or recast as “No, that puppy won’t bite.” When parents of children with SLI recast a child’s utterance, they are most likely to recast the noun phrase, in contrast to parents of non-SLI children, who are most likely to recast the verb phrase. This is unfortunate because children with SLI have particular difficulty with the verb phrase (Fey, Krulik, Frome Loeb, Proctor-Williams, 1999). Processing Factors Although children with SLI demonstrate typical nonverbal intelligence, they may also demonstrate cognitive impairments not exhibited on standard intelligence measures (Kamhi, Minor, & Mauer, 1990; Leonard, 1987). As mentioned previously, these children do not seem to employ active processing strategies that use contextual information and stored knowledge. Informationprocessing problems of children with SLI occur with incoming information, in memory, and in problem solving (Ellis Weismer, 1991; L. Nelson, Kamhi, & Apel, 1987). In addition, children with SLI demonstrate slower linguistic and nonlinguistic processing on both expressive and receptive tasks than age-matched children developing typically (Leonard, 1998; C. A. Miller, Kail, Leonard, & Tomblin, 2001; Windsor & Hwang, 1999a). These characteristics suggest limitations in cognitive processing capacity in which tradeoffs exist between accuracy and speed of responding (Ellis Weismer & Evans, 2002). In the rapid give-and-take of conversation this tradeoff results in reduced processing and storage of phonological information, inefficient fast mapping and novel word learning, slow word recognition, and ineffective sentence comprehension (Bishop, North, & Donlan, 1996; Dollaghan & Campbell, 1998; Edwards & Lahey, 1998; Ellis Weismer & Hesketh, 1996; Ellis Weismer, Tomblin, Zhang, Buckwalter, Chynoweth, et al., 2000; C. A. Miller et al., 2001; Montgomery 2000a; Windsor & Hwang, 1999b). Specific difficulty with grammatical markers, such as -ed and plural -s, suggests that the brevity of these morphemes in speech may be a factor. Children with SLI perform considerably below agematched typically developing children in sensitivity to sound contours and sound duration (Corriveau, Posquine, & Goswami, 2007). In addition, these children demonstrate difficulty in nonword (lemprish) repetition. Taken together, these characteristics may indicate underlying language-processing deficits in phonological working memory, where words are held while processed. More specifically, these difficulties may be in the simultaneous processing of analyzing the phonological structure of nonwords and encoding them for production (Marton & Schwartz, 2002). Working memory is an active process that allows for access to a small number of items in conscious awareness. Incoming linguistic knowledge is held in working memory while processed. Limitations in cognitive processing ability and executive function relative to working memory may interact with various modes of input and output to restrict information-processing capacity (Hoffman & Gillam, 2004). The result is linguistic tradeoffs. For example, children with SLI make more production errors as sentences become more complex. The reduced phonological processing capacity of children with SLI may impair their ability to process these grammatical markers (Montgomery & Leonard, 2006). In short, deficits in phonological working memory mean less capacity to store phonological information, accounting for the poor performance of children with SLI on language tasks (Leonard, Ellis Weismer, Miller, Francis, Tomblin, et al., 2007). This situation may be compounded by further deficits in phonological encoding, phonological (sound and syllable) awareness or sensitivity, word knowledge, or a combination of deficits in several areas (Archibald & Gathercole, 2006a; Graf Estes, Evans, & Else-Quest, 2007). That said, it is important to note that children with SLI do not exhibit the phonological awareness difficulties that underlie dyslexia (Catts, Adlof, Hogan, & Ellis Weismer 2005).

Chapter 2

Encoding

Language Impairments

47

Recognition

TD Children

Children with SLI

FIGURE 2.2

Neurological processing of TD children and those with SLI. Size of arrows reflects correlational values. Source: Ellis Weismer, Plante, Jones, & Tomblin (2005).

Although poor recall of linguistic units suggests limits in verbal working memory, poor performance on nonlinguistic serial memory tasks suggests that the deficit may not be language specific (Ellis Weismer, Evans, & Hesketh, 1999; Fazio, 1998; Montgomery 2000a, 2000b). In other words, the language performance of children with SLI may be indicative of overall problems in working memory. If the storage and processing demands on working memory exceed the resources available, processing suffers. For example, comprehension of longer, more grammatically complex sentences places considerable strain on the processing abilities of children with SLI, resulting in more comprehension errors (Deevy & Leonard, 2004). With inefficient allocation of mental resources to acoustic-phonetic processing, the child with SLI is easily overwhelmed by rapidly incoming information and cannot effectively employ lexical retrieval, recognition, and integration processes (Montgomery, 2002a). Children with SLI orient more slowly to new information, have more limited capacity for sustained focus, and have greater difficulty refocusing and shifting focus than TD age-matched peers (Gillam, Cowan, & Day, 1995; Marler, 2000; Marler, Champlin, & Gillam, 2001; Riddle, 1992). Lack of attention contributes to inefficiency in forming representations of incoming acoustic information (Helzer, Champlin, & Gillam, 1996; Sussman, 1993). Temporal processing abilities are further slowed by simultaneous multiple linguistic operations. The result of storage/access memory deficits is lower rates of vocabulary learning (Swisher & Snow, 1994). Diminished phonological working memory for words also affects sentence comprehension (Montgomery, 1995). Imagine that you have limited working memory, but communication is occurring at a rapid rate. As the input increases, you are easily overwhelmed, slowing the entire process. Your limited memory makes it increasingly difficult to hold information as more comes in, slowing the process even more.You begin to lose information as more comes in. It’s increasingly difficult to relate new information to partially processed old information. Maybe you’ve experienced this when you’ve tried to communicate in another language. Now you get some inkling of one aspect of language processing for children with SLI.

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Conclusion Much discussion has taken place concerning the viability of SLI as a separate category of language impairment. It has been suggested that SLI is not a distinct disorder category but merely represents children with limited language abilities as the result of genetic and/or environmental factors (Leonard, 1987, 1991; Tomblin, 1991). One recent study of over a thousand preschool children failed to find a qualitatively distinct group corresponding to children with SLI (Dollaghan, 2004). Some educators have suggested that SLI may not even be a useful concept, especially because clinical tools are unable to diagnose it easily and accurately (Aram, Morris, & Hall, 1993). For now, the best diagnostic techniques appear to be rote memory tasks, such as counting or sequential digit recall, nonsense word repetition, rule induction (see description of dynamic assessment of children with LEP, pages 114–115), story recall, grammatical completion, especially verb markers, number of different words in a speech sample, and memory plus interpretation tasks while listening or reading (Fazio, Naremore, & Connell, 1996; Montgomery, 1995; Rice & Wexler, 1996; Watkins, Kelly, Harbors, & Hollis, 1995). Memory and awareness tasks for intervention are presented in Table 2.9. PE RVASIVE DEVE LOPM E NTAL DISOR DE R /AUTISM SPECTR U M DISOR DE R The fourth, revised edition of the American Psychiatric Association’s Diagnostic and Statistical Manual on Mental Disorders (DSM-IV-TR) (2000) lists autism along a continuum labeled pervasive developmental disorder (PDD). Autism spectrum disorder (ASD) is at the more severe extreme, while a milder form of the disorder is called pervasive developmental disorder–not otherwise specified (PDD-NOS) (Bauer, 1995a, 1995b). In actual practice, children are labeled as ASD when the severe form of the disorder exists and as simply PDD or another disorder when the milder form exists. Some children with PDD may be labeled with Asperger’s syndrome or are mislabeled as learning disabled or ADHD. If this is not confusing enough, other children with PDD may be labeled hyperlexic and may exhibit some characteristics of ASD while others with this label appear more like children with learning disabilities. These labels are not assigned arbitrarily but are based on characteristics exhibited by the child. Don’t be too confused by all these labels. We shall try to sort out these differences in the following discussion. The American Psychiatric Association (2000) defines ASD as an impairment in reciprocal social interaction with a severely limited behavior, interest, and activity repertoire. The Autism Society of America further defines ASD as a disorder that has an onset prior to 30 months of age and that consists of disturbances in the following areas: rates and the sequence of motor, social-adaptive, and cognitive skills • Developmental to sensory stimuli—hyper- and hyposensitivity in audition, vision, tactile stimulation, • Responses motor, olfactory, and taste, including self-stimulatory behaviors and language, cognition, and nonverbal communication, including mutism, echolalia, and • Speech difficulty with abstract terms to appropriately relate to people, events, and objects, including lack of social behaviors, • Capacity affection, and appropriate play ASD is found in males four times more frequently than in females (Bauer, 1995a) and affects 1 in 500 children.

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Within the last few years there has been an explosion in the number of children in the United States diagnosed as PDD. Whether because of better diagnosis or a real increase, 1 in 150 children age 10 and younger are now classified as having some variety of PDD. In real numbers, that equals 300,000 children and over 1 million adults in the United States. As in other language impairments discussed in this chapter, children with ASD are a diverse group. For example, to the best of our ability to measure, slightly more than half of the children with ASD have IQs below 50, with the remainder evenly split between 50–70 and 71 and above (Schreibman, 1988). The best prognostic or recovery indicators are a nonverbal IQ above 70 and meaningful speech by age 5 (Bauer, 1995b). In general, the age of detection of ASD varies with severity and developmental delays, especially in communication and social interaction. The more intense the symptoms, the poorer language and overall development (Pry, Petersen, & Baghdadli, 2005). Although it is rare that the disorder is identified prior to 18 months of age, infants with ASD have been described as either lethargic, preferring solitude and making few demands, or highly irritable, with sleeping problems and screaming and crying (Coleman & Gillberg, 1985). Usually, between 18 and 36 months, the signs become more pronounced, including more frequent tantruming, repetitive movements and ritualistic play, extreme reactions to certain stimuli, lack of pretend and social play, and joint attention and communication difficulties including a lack of gestures. In approximately 20 percent of the cases, parents report typical development until 24 months, especially among girls (Bauer, 1995a). Early identification is often difficult because of the lack of obvious medical problems and the early typical development of motor abilities. Infrequently, onset occurs in later childhood. Recent data suggests that young children with PDD exhibit clusters of impairment in joint or mutual attending, symbolic play, and social affective communication (Wetherby, Prizant, & Hutchinson, 1998). Development often proceeds in spurts and plateaus, rather than smoothly. Most areas of development are affected by delay and disorder, although occasionally one area, such as mechanical or mathematical abilities, is typical or above. I have worked with children well above average in mathematics but unable to dress themselves or to participate in meaningful conversations. Motor behaviors may include toe walking, rocking, spinning, and, in extreme cases, self-injurious behaviors, such as biting, hitting, and head banging. One adolescent with whom I worked was covered with scars and scabs from self-inflicted scratches and bites. Another child pounded his head with his fist an average of more than 7,000 times in a five-hour school day. TABLE 2.9

Intervention for Memory and Awareness with Children with SLI

Naming letters and objects

Repeating novel and nonsense (“funny”) words

Recalling spoken sentences

Rhyming games

Using melody as a memory aid

Recalling of words that begin with specific phonemes

Listening to stories and nursery rhymes

Guessing games based on cumulative cues

Repeating nursery rhymes

Rehearsing verbally

Acting out pictures

Categorizing words and objects

Acting out rhymes Using gestures to aid recall Source: Adapted from Fazio (1996); Montgomery (1995).

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Although it is beyond the scope of this text to discuss intervention for self-injurious behaviors, we should note that they often represent ineffectual ways of communication or stress associated with this lack of communication and can be reduced in some children by providing new more effective ways of communicating (Buschbacher & Fox, 2003). Children with ASD exhibit sensory modulation dysfunction (SMD). Sensory modulation occurs within the central nervous system (CNS) as it attempts to balance excitation and inhibition inputs arising within one’s sensory mechanism with those occurring external to the body. Modulation within the CNS occurs when the electrical properties of neurons change as a result of neurotransmitters or hormones. Typically, sensations are detected and responded to in a routine manner that is appropriate and adaptive (Lane, 2002). SMD is a mismatch between the external demands and a person’s internal system characteristics, resulting in behavior that is underresponsive or overresponsive (Hanft, Miller, & Lane, 2000). For children with ASD, stimuli must be within the limits of a child’s tolerance and expectation. Children with ASD fluctuate between the two extremes, exhibiting overresponsiveness until overload occurs and results in shutdown of the process and a defensive or withdrawal response. Over- and underresponsiveness to stimuli may be found in the same child. For example, loud noises may get no response from a child, while whispering results in a catastrophic response. In general, children with ASD tend to prefer shiny objects, especially those that spin; things that can be twirled; and noises they produce themselves, such as teeth grinding. Children with ASD seem to prefer routines and may become extremely upset with change. Individual children may have very definite preferences in taste, touch, and smell. I worked with one child whose only food preference was dill pickles. Self-stimulatory behaviors may include rocking, spinning, and hand flapping. Relational disorders may be the most distressful aspect of ASD, especially for parents (Bauer, 1995b; Bristol, 1988). In particular, children with ASD often avert their gaze or stare emptily and lack a social smile, responsiveness to sound, and anticipation of the approach of others. Parents often are treated as “things” or, at best, no different from other people. The effect on parents can be imagined. As mentioned, children with a milder form of the disorder are labeled with pervasive developmental disorder–not otherwise specified, PDD-NOS, or simply PDD. Children with PDD-NOS exhibit many of the characteristics of ASD but to a lesser degree. For example, they may have difficulty with social behavior and exhibit poor eye contact and poor use of gestures and facial expressions. Their grammar may be disordered, and they may use echolalia. Compared to children with either ASD or Asperger’s syndrome, ASD children with PDD-NOS have levels of functioning performance (communication, daily living and social skills, IQ, and age of acquisition of language) between the two (Walker, Thompson, Zwaigenbaum, Goldberg, Bryson, et al., 2004). One subgroup of PDD-NOS has significant impairments in social communication but fewer repetitive behaviors than seen in children with ASD. Asperger’s syndrome (AS), a neurodevelopmental disorder less severe than ASD in which cognitive, language, and self-help skills are supposedly not disordered (American Psychiatric Association, 2000), nevertheless is manifested in subtle language impairments with little delay, along with social interaction difficulties, restricted interests, and repetitive behaviors. In general, compared to children with high-functioning autism (HFA), children with AS have high verbal IQ and low nonverbal or performance IQ, while in most children with HFA the pattern is reversed; however, there is considerable overlap between HFA and AS (Ghaziuddin & Mountain-Kimchi, 2004). Communication similarities and differences are presented in Figure 2.3. The heterogeneity of both populations increases the need for thorough evaluation and individualized intervention (Tsatsanis, Foley, & Donehower, 2004).

Chapter 2

Asperger’s Syndrome Difficulties with Verbal learning style No language delay Parallel but little social play Verbose style “Fact gathering” focus Poor intonation and volume

Unique

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High Functioning Autism Difficulties with Perceiving and clarifying emotions/intentions of others and regulating self Initiating and maintaining conversations Turn-taking Recognizing and repairing breakdowns Interpreting nonverbal cues

Difficulties with Visual learning style Language delay Delays in both types of play Passive style Visuospatial and mechanical focus Constricted range of intonations

Shared

Unique

FIGURE 2.3 Similarities and differences in the communication of children with Asperger’s syndrome and high-functioning autism. These characteristics are generalities, and individual children will vary greatly. Source: Adapted from Rubin & Lennon (2004).

Language difficulties with AS include verbosity, a pedantic speaking style, inability to understand the rules of social behavior, including conversation, and an intense interest in a limited range of one or two topics. Children with AS may be poorly organized but perfectionist in their demands, with ability to concentrate deeply and difficulty transitioning. Still other children may be labeled with hyperlexia, a disorder affecting boys and girls at a ratio of 7:1 and characterized by a spontaneous early ability to read—often at age 21⁄2 or 3—but with little comprehension (Aram, 1997). Children with hyperlexia have an intense preoccupation with letters and words and extensive word recognition by age 5 but exhibit language and cognitive disorders in reasoning and in perceiving relationships. In addition to delayed language, these children experience difficulty with connected language in all modalities, especially integrating it with context in order to derive meaning (Snowling & Frith, 1986). As with all the disorders discussed, there is a range of severity. Some children with mild forms may be mislabeled as learning disabled depending on the characteristics present. This is not a science but a fine art. Language Characteristics Communication problems are often one of the first indicators of possible ASD. These may include a failure to begin gesturing or talking, a seeming noninterest in other people, or a lack of verbal responding. Lack of communication skills is one of the most significant stress factors for families of children with ASD and one of the earliest indicators of the disorder. All children with ASD are not alike in development of communication skills. In general, children who say and imitate more words, have better pretend-play skills with objects, and use gestures more often to initiate joint attending, such as pointing at entities to direct attention, have the most rapid expressive vocabulary growth (Smith, Mirenda, & Zaidman-Zait, 2007). Calling attention to entities

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through gestures and sounds seems to be important for comprehension of new vocabulary words (McDuffie, Yoder, & Stone, 2005). The importance of these factors is similar to that found in typical development (Watt, Wetherby, & Shumway, 2006). Poor social interaction and poor language and communication skills are extremely characteristic of children with ASD. Speech does not seem to be difficult for those who speak, although speech is often wooden and robotlike, lacking a musical quality (Schuler & Prizant, 1987). While as many as 25 percent of children with ASD may have typical language (Kjelgaard & TagerFlusberg, 2001), between 25 and 60 percent of the population with ASD remains mute or nonspeaking. Until recently, this lack of speech also has meant that they remained noncommunicating. This situation is changing for some, but not all, children using augmentative and alternative communication (AAC). Those children using speech and language may demonstrate immediate or delayed echolalia, a whole or partial repetition of previous utterances, often with the same intonation. In fact, most children with ASD who learn to talk go through a period of using echolalia (Prizant, Schuler, Wetherby, & Rydell, 1997). Immediate echolalia is variable, increasing in highly directive situations, with unknown words, following an inability to comprehend, in the presence of an adult, in unfamiliar situations, in face-to-face communication with eye contact, and with longer, more complex utterances (Charlop, 1986; Violette & Swisher, 1992). Immediate echolalia also has been found to signal agreement in some children. No such data are available for delayed echolalia. One child with whom I worked would repeat many of the utterances directed to him during the day as he lay in bed prior to sleep. In general, pragmatics and semantics are affected more than language form (Lord, 1988). The give-and-take of conversation seems to be particularly difficult. The range of communication functions is often very limited, and its development is sequential rather than synchronous, as seen in children developing typically. In addition, functions may be expressed in an individualistic or idiosyncratic manner, such as saying “Sesame Street is a production of the Children’s Television Workshop” for “Goodbye.” Children with ASD also seem to have difficulty matching the content and form of language to the context (Swisher & Demetras, 1985). Occasionally, children will incorporate rote utterances, such as the child who says “Attention, K-Mart shoppers” to get attention. Even those individuals who have acquired language often have peculiarities and irregularities in their communication. Specific language characteristics are listed in Table 2.10. Although errors in language form occur in children with ASD, these are not as severe as those for semantics and pragmatics. Syntactic errors that are present seem to represent lack of underlying semantic relationships. Phonological development appears to follow the same sequence as that of children developing typically and not to be delayed inordinately. Possible Causal Factors In the past, children with ASD have been classified as having an emotional-, physical-, environmental-, or health-related impairment. The cause may be any and all of these, although the primary causal factors are probably biological (Schreibman, 1988). Even within this population, neuroanatomical and neurochemical features may differ. Biological Factors Approximately 65 percent of all individuals with ASD have abnormal brain patterns. The incidence of autism accompanying prenatal complications, fragile X syndrome, and Ritt syndrome, a degenerative neurological condition, and among those with a family history of autism

Chapter 2

TABLE 2.10

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Language Characteristics of Children with ASD

Pragmatics

Deficits in joint attending. Difficulty initiating and maintaining a conversation, resulting in much shorter conversational episodes. Limited range of communication functions. Difficulty matching form and content to context. May perseverate or introduce inappropriate topics. Immediate and delayed echolalia and routinized utterances. Few gestures used; misinterpretation of complex gestures. Overuse of questions, frequent repetition. Frequent asocial monologues. Difficulty with stylistic variations and speaker-listener roles. Gaze aversion, seeming use of peripheral vision.

Semantics

Word-retrieval difficulties, especially for visual referents. Underlying meaning not used as a memory aid. More inappropriate answers to questions than age-matched peers.

Syntax/Morphology

Morphological difficulties, especially with pronouns and verb endings. Construction of sentences with superficial form, often disregarding underlying meaning. Less complex sentences than mental-age-matched peers developing typically. Overreliance on word order.

Phonology

Phonology variable within individual child, often disordered. Developmental order similar to children developing typically. Least affected aspect of language.

Comprehension

Impaired comprehension, especially in connected discourse such as conversations.

Source: Based on Alpert & Rogers-Warren (1984); Greenspan & Wieder (1997); Lewy & Dawson (1992); Lord (1988); Lord, Rutter, Goode, Heemsbergen, Jordan, et al. (1989); Rumsey, Rapoport, & Scoery (1985); Swisher & Demetras (1985).

is higher (Schreibman, 1988). In addition, ASD is often accompanied by mental retardation and seizures. All of these suggest a biological basis but do not explain the actual disorder. Other studies have found unusually high levels of serotonin, a neurotransmitter and natural opiate; abnormal development of the cerebellum, the section of the brain that regulates incoming sensations; multifocal disorders of the brain; and impairment of the neural subcortical structures with accompanying impairment in cortical development (Courchesne, 1988; Schopler & Mesibov, 1987; Schreibman, 1988). Recent studies have suggested a genetic link in ASD, although is seems doubtful that a solitary autism gene exists (Wentzel, 2000). It is more likely that several genes are involved and may be shared with other disorders. Social-Environmental Factors Early studies blamed parents for ASD. No basis has been found for this conclusion. In general, parents interact with their children at the appropriate language level.

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Processing Factors Children with ASD have difficulty analyzing and integrating information. When attending, they tend to fixate on one aspect of a complex stimulus, often some irrelevant, minor detail. In other words, responding is very overselective. This fixation, in turn, makes discrimination difficult. Overall processing by these children has been characterized as a “gestalt” in which unanalyzed wholes are stored and later reproduced in identical fashion, as in echolalia. In this relatively inflexible system, input is examined in its entirety rather than analyzed into its component parts. Information usually is reproduced in a context that is in some way similar to the initial context. This reliance on unanalyzed wholes could account for the tendency of children with ASD to repeat an agrammatical sentence, rather than to correct it as language-matched children with ID will do. It is possible that children with ASD depend more heavily on simultaneous language processing than on successive language processing. The behavior of children with ASD suggests that very little of the world makes sense to them. They seem to overload quickly. Information “swallowed” whole could quickly “fill” the system. Storage of unanalyzed wholes also might hinder memory. Children with autism reportedly are less able to use environmental cues to aid memory, possibly because those cues do not exist as separate entities in the child’s memory. It is also difficult for these children to organize information on the basis of relationships between stimuli. In addition, children with ASD have difficulty transferring or generalizing learned information from one context to another. This difficulty reflects the inability of these children to identify the relevant contextual information. Conclusion As with other disorders that have been discussed, PDD demonstrates heterogeneity. Great differences are found in severity, especially in communication abilities. In general, these differences affect the pragmatic and semantic aspects of language and may reflect processing difficulties such as stimulus overselectivity and storage of unanalyzed wholes. Early intervention (EI) is critical to maximizing outcomes for children with ASD, but early identification is often difficult. Although SLPs alone do not make evaluations of children for ASD, they are a vital part of the evaluative team (Prelock, Beatson, Bitner, Broder, & Ducker, 2003). The American Academy of Neurology and Child Neurology Society (Filipek, Accordo, Baranek, Cook, Dawson, et al., 1999) has suggested that failure to meet the following milestones indicated need for further evaluation: babbling by 12 months • No No gesturing by 12 months • No single words by 16 months • No two-word spontaneous speech by 24 months • Loss of language or social skills at any age • These signs were specific to ASD. In addition, children with ASD also demonstrate deficits in joint attention and symbolic communication (Wetherby, Prizant, & Schuler, 2000). Given the limitations of current research, it may not be possible at this time to make a definitive diagnosis prior to 24 months of age (Woods & Wetherby, 2003).

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B RAI N I NJ U RY Children with brain injury are often confused with other children who have impairments, such as children with LLD, ID, or emotional disorders. Children with brain injury differ greatly as a result of the site and extent of lesion, the age at onset, and the age of the injury. In general, the smaller the damaged area, the better the prognosis, or chance of recovery. Brain injury in children may result from trauma, cerebrovascular accident (CVA) or stroke, congenital malformation of the neural blood vessels, convulsive disorders, or encephalopathy, such as infection or tumors. Each has different characteristics; however, some similarities in language occur. Only the most prevalent types of injury are discussed here. Traumatic Brain Injury (TBI) Approximately 1 million children and adolescents in the United States have traumatic brain injury, or TBI, diffuse brain damage as the result of external physical force, such as a blow to the head received in an auto accident. TBIs are not congenital or degenerative. Individuals may range from nearly full recovery to a vegetative state in some very severe cases. Although the chances of survival have improved greatly in recent years, long-term disability is a continuing public health problem (Zitnay, 1995). Deficits may be cognitive, physical, behavioral, academic, and linguistic (Ewing-Cobbs, Fletcher, & Levin, 1985; Rosen & Gerring, 1986; Savage, 1991; Savage & Wolcott, 1988; Ylvisaker, 1986). Cognitive deficits include perception, memory, reasoning, and problem-solving difficulties. Such deficits may be permanent or temporary and may partially or totally affect functioning ability. Psychological maladjustment or acting-out behaviors, called social disinhibition, may also occur. For example, I once evaluated a young man with TBI who kept insisting on kissing my hand. Other characteristics include lack of initiative, distractibility, inability to adapt quickly, perseveration, low frustration levels, passiveaggressiveness, anxiety, depression, fear of failure, and misperception. Severity may range from a mild concussion, defined as a loss of consciousness for less than 30 seconds, through moderate TBI, a loss of consciousness or posttraumatic amnesia for 30 minutes to 24 hours, with or without skull fracture, to severe TBI, consisting of a coma for 6 hours or longer. Severity is not directly related to the deficits mentioned above (Russell, 1993). Variables that affect recovery are extremely independent and are complicated by some of the characteristics of the population at risk for TBI (Lehr, 1989; Middleton, 1989; Savage, 1991). In general, this population has a lower IQ, higher social disadvantage, poorer schooling, and more behavioral and physical difficulties prior to injury than the general population (N. Nelson & Schwentor, 1990). Other variables include degree and length of unconsciousness, duration of posttraumatic amnesia, age at injury, age of injury, and posttraumatic ability (Dennis, 1992; Russell, 1993). In general, shorter, less severe unconsciousness, shorter amnesia, and better posttraumatic abilities indicate better recovery. Age at the time of injury is a less definitive factor because the child is developing when the injury occurs. Younger children may exhibit more severe and more long-lasting problems. Although younger children have less to recover, they also do not have the benefit of as much past learning as older children. Age of the injury also can be an inaccurate predictor. In general, the older the injury, the less chance of change, but this aspect is complicated by the delayed onset of some deficits (Russell, 1993). Neural recovery over time is often unpredictable and irregular. Language Characteristics Language problems are usually evident even after mild injuries. Pragmatics seem to be the most disturbed aspect of the language of children with TBI. This fact can be noted

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in the narratives and in conversation of these children (Chapman, 1997; Liles, Coelho, Duffy, & Zalagens, 1989; Mentis & Prutting, 1987). Utterances are often lengthy, inappropriate, and off-topic, and fluency is disturbed (Ylvisaker, 1986). Language comprehension and higher functions such as figurative language and dual meanings also may be affected. A child may lose his or her train of thought in conversations, while in narratives the same child may not retain the central focus of the story, thus deleting important information (Chapman, Watkins, Gustafson, Moore, Levin, et al., 1997). By comparison, language form is relatively unaffected. The majority of children with TBI regain the ability to manipulate language form and content (Chapman, Levin, Matejka, Harwood, & Kufera, 1995). Surface structure may seem relatively unimpaired. A child’s language may be effective in school until the third or fourth grade, when students are required to use higher language abilities to analyze and synthesize (Russell, 1993). Semantics, especially concrete vocabulary, is also relatively undisturbed, although word retrieval, naming, and object description difficulties may be present (Ewing-Cobbs, Levin, Eisenberg, & Fletcher, 1987). Other characteristics are listed in Table 2.11. Some deficits will remain long after the injury even when overall improvement is good (T. Campbell & Dollaghan, 1990; Ewing-Cobbs et al., 1987; Jordan, Ozanne, & Murdoch, 1988). Although there is considerable variability among children with TBI, many subtle deficits remain, especially in pragmatics (Dennis & Barnes, 1990). Possible Causal Factors Obvious biological and physical factors are involved in TBI. More important is the manner in which informational processing is affected. As mentioned, children with TBI are often inattentive and easily distractible. Attention fluctuates, and they have difficulty focusing on a task. TABLE 2.11

Language Characteristics of Children with Traumatic Brain Injury (TBI)

Pragmatics

Difficulty with organization and expression of complex ideas. Off-topic comments. Ineffectual, inappropriate comments. Frequency of eye gaze is appropriate during conversation. Less complex narratives, containing fewer words and shorter, less sentences complexity, and fewer episodic elements. Short narratives include story grammar and cohesion, as do those of typically developing peers.

Semantics

Word retrieval, naming, and object description difficulties, although vocabulary relatively intact. Automatized, overlearned language relatively unaffected.

Syntax/Morphology

Sentences may be lengthy and fragmented.

Phonology

Few phonological difficulties, but there may be some dysarthria or apraxia due to injury.

Comprehension

Some problems due to inattention and speed of processing. Poor auditory and reading comprehension. Difficulty with sentence comprehension due to difficulty assigning meaning to syntactic structure. Most routinized, everyday comprehension unaffected. Vocabulary comprehension usually unaffected, except for abstract terms.

Source: Based on Butler-Hinz, Caplan, & Waters (1990); Ewing-Cobbs, Levin, Eisenberg, & Fletcher (1987); Hay & Moran (2005); Jordan, Murdock, & Buttsworth (1991); Mentis & Prutting (1987); Sarno, Buonaguro, & Levita (1986); Savage & Wolcott (1988); Turkstra (2005); Ylvisaker (1986).

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All aspects of organization—categorizing, sequencing, abstracting, and generalization—are affected. Children with TBI seem stimulus-bound—unable to see relationships, make inferences, and solve problems (Cohen, 1991; Ylvisaker, 1986). They evidence difficulty formulating goals, planning, and achieving (Ylvisaker & Szekeres, 1989). This deficiency often is masked by intact vocabulary and general knowledge. Finally, children with TBI exhibit memory deficits in both storage and retrieval. Long-term memory prior to the trauma is usually intact. Techniques presented in Table 2.6 might be helpful with these children. Cerebrovascular Accident (CVA) Cerebrovascular accidents occur when a portion of the brain is denied oxygen, usually because of a rupture in a blood vessel serving the brain. Most frequently, damage is specific and localized. Patterns of recovery suggest that adjoining portions of the cortex, the surface of the cerebrum, or upper brain, augment the functioning of the damaged portion (Papanicolaon, DiScenna, Gillespie, & Aram, 1990). CVAs usually are found in children with congenital heart problems or arteriovenous (blood vessel) malformations in the brain. Prognosis is generally good (Aram & Ekelman, 1987; Aram, Ekelman, & Whitaker, 1986, 1987). Naturally, the variability will be great, depending on the site and extent of the lesion. Language problems often accompany left hemisphere damage, although any brain damage has the potential to disturb language functioning. Language Characteristics Long-term subtle pragmatic difficulties are common. Language form usually returns quickly, although performance may deteriorate when demands increase. Word retrieval may be extremely difficult at first, with deficits in both speed and accuracy (Aram, 1988). Language comprehension also is affected initially. Children usually recover, although higher level academic and reading difficulties may persist (Aram & Ekelman, 1988). Conclusion The underlying relationship between cognition and language varies with age and with the aspect of language studied. At many points in development, we are not able to describe the exact relationship. It is not surprising that we cannot fully explain the mechanisms at work when the brain is injured. Still, we can predict that vocabulary and structural rules will return more easily than higher order functions, such as conversational skills that require complex synthesis of language form, content, and use. Even those children who seem to recover may continue to exhibit long-term subtle pragmatic difficulties. MALTR EATM E NT: N EG LECT AN D AB USE Each year in the United States, approximately 1.2 percent of children, or 900,000 children, are maltreated sufficiently for this information to be reported to the authorities (U.S. Department of Health and Human Services [DHHS], 2005). A study of over 50,000 typically developing children found that 9 percent had been maltreated (Sullivan & Knutson, 2000). The percentage is higher for young children and for those with disabilities. In the same study, 31 percent of children with disabilities and 35 percent of children with speech/language impairment had been maltreated. Although maltreatment occurs across the income spectrum, children from families earning less than $15,000 per year are over twenty times more likely to be abused than those from families earning at least twice that amount (Kapp, McDonald, & Diamond, 2001). It is believed that the increased eco-

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nomic, social, and health problems and lower levels of education and employment of the poor increase the risk of maltreatment. Table 2.12 presents the types of neglect and abuse that have been identified (Sparks, 1989). Of the 900,000 maltreated annually, approximately 63 percent are neglected, 17 percent physically abused, 9 percent sexually abused, and 7 percent psychologically abused (U.S. DHHS, 2005). Until recently, these children were not identified as having distinct language problems. The effect of each type of abuse varies with each child. Neglect and abuse are extreme examples of a dysfunctional family and are a sign of the type of social environment in which the child learned language (Cicchetti, 1987; Cicchetti & Lynch, 1993; Salzinger, Feldman, Hammer, & Rosario, 1991). Although neglect and abuse are rarely the direct cause of the communication problem, the context in which they occur directly influences a child’s development. Complex trauma, or exposure both to domestic violence or maltreatment and to physical, sexual, and psycho-emotional abuse, rarely occurs in isolation and is often associated with substance abuse, mostly alcohol abuse, by parents. Adults who abuse alcohol are prone to violence, and their children are at risk (Willis & Silovsky, 1998). Whether these causal factors occur alone or together, they can lead to developmental difficulties across the lifespan (Timler, Olswang, & Coggins, 2005). Children exposed to both prenatal alcohol and postnatal abuse and neglect have lower intelligence scores and more severe neurodevelopmental deficits than traumatized children who are not prenatally exposed to alcohol (Henry, Sloane, & Black-Pond, 2007). Developmental deficits occur in language, attention, memory, visual processing, and motor skills. Sensory modulation dysfunction (SMD), introduced in the ASD section of this chapter, is also exhibited by children exposed to prenatal alcohol and/or postnatal abuse and neglect. Simply put, children who have been traumatized experience biological brain changes as a result (Atchison, 2007). Characterized as hyperarousal, these changes are associated with acceleration in nervous system areas responsible for perception and processing of potentially threatening sensations. The accompanying physiological changes, including release of certain stress hormones, influence thoughts, feelings, and actions. In a state of fear-related activation, the child responds to perceived threats with primitive, TABLE 2.12

Types of Neglect and Abuse

Physical neglect

Abandonment with no arrangement for care, including inadequate supervision, nutrition, clothing, and/or personal hygiene, and/or failure to seek needed or recommended medical care.

Emotional neglect

Failure to provide a normal living experience, including attention and affection, and/or refusal of treatment or services recommended by professional personnel.

Physical abuse

Bodily injury, such as neurological damage, or death from shaking, beating, and/or burning.

Sexual abuse

Both nonphysical abuse, such as indecent exposure or verbal attack, and physical abuse, such as genital-oral stimulation, fondling, and/or sexual intercourse.

Emotional abuse

Excessive yelling, belittling, teasing/verbal attack, and/or overt rejection.

Source: Adapted from Sparks (1989).

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reflexive, and aggressive reactions. Over time, the hypervigilant state of the child leads to apprehension, fear, attention difficulties, and restlessness (Lane, 2002). Persistent activation of this response can result in a maladaptive, persistent state of fear (Perry, 1997). Language Characteristics Maltreated children have less complex language than nonmaltreated children (Eigsti & Cicchetti, 2004). All aspects of language are affected; however, it is in language use that children who are neglected and abused exhibit the greatest difficulties (see Table 2.13). In general, children who are neglected and abused are less talkative and have fewer conversational skills than their peers. Utterances and conversations are shorter than those of their peers. They are less likely to volunteer information or to discuss emotions or feelings. In school, these children have depressed verbal language performance. A high correlation is found between deficient verbal and reading ability and neglect and abuse (Burke, Crenshaw, Green, Schlosser, & Strocchia-Rivera, 1989). Possible Causal Factors Certainly, negative social-environment factors are important in the development of language by children who are neglected and abused, but biological factors should not be overlooked. Medical and health problems among the poor also can contribute. Direct effect is difficult to determine because of the multiplicity of overlapping factors, especially among the poor (Fox, Long, & Langlois, 1988; McCauley & Swisher, 1987; Sparks, 1989). Biological Factors Neglect and abuse are not limited to poor families, but in these families or in cases of extreme neglect, biological factors also may contribute. Poor maternal health, substance abuse, poor or nonexistent pediatric services, and poor nutrition can all affect brain development and maturation. Physical abuse also may cause lasting physical or neurological damage. We do not know the long-term effects on the brain of lack of environmental stimulation. TABLE 2.13

Language Characteristics of Children Who Are Neglected and Abused

Pragmatics

Poor conversational skills. Inability to discuss feelings. Shorter conversations. Fewer descriptive utterances. Language used to get things done with little social exchange or affect.

Semantics

Limited expressive vocabulary. Fewer decontextualized utterances, more talk about the here and now.

Syntax/Morphology

Shorter, less complex utterances.

Phonology

Similar to peers.

Comprehension

Receptive vocabulary similar to peers. Auditory and reading comprehension problems.

Source: Based on Coster & Cicchetti (1993); Coster, Gersten, Beeghly, & Cicchetti (1989); Culp, Watkins, Lawrence, Letts, Kelly, & Rice (1991); Fox, Long, & Langlois (1988).

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Social-Environmental Factors As in all children, the early language experiences of a child with a history of maltreatment influence the underlying social cognitive behavior of the infant or toddler (Lohmann & Tomasello, 2003). When children are repeatedly exposed to violence and stress, they compensate through behaviors that ensure their survival. These strategies can interfere with critical brain development in areas of socioemotional learning. As a result, these children have limited ability to predict and interpret the beliefs and intentions of others and to self-regulate their own language use. Some maltreated children exhibit alexithymia, difficulty in the identification, regulation, and understanding of feelings in others and, in extreme cases, in themselves. It is hypothesized that traumatic experiences result in a disassociation between right-hemisphere emotions and left-hemisphere expression (Schore, 2001). As a result, children with alexithymia may have behavioral problems or outbursts of aggressive behavior. Either or both parents may be neglectful or abusing, but it is a mother’s or caregiver’s everyday responsiveness to a child that has the most effect on language development. The quality of the child– mother attachment is a more significant factor in language development than is maltreatment and can moderate or exacerbate the effects of neglect or abuse (Gersten, Coster, Schneider-Rosen, Carlson, & Cicchetti, 1986; Mosisset, Barnard, Greenberg, Booth, & Spicker, 1990). Several factors, including childhood loss of a parent, death of a previous child, pregnancy complications, birth complications, current marital or financial problems, substance abuse, maternal age, and/or illness, can disturb maternal attachment. In turn, mothers may adopt two general patterns of interaction (Crittenden, 1988). Most abusive mothers are controlling, imposing their will on the child. As controllers, they tend to ignore a child’s initiations, thus decreasing the amount of verbal stimulation received by that child. Neglecting mothers, however, are unresponsive to their infant’s behaviors because they have low expectations of deriving satisfaction from the infant. Either situation includes a lack of support for the development of meaningful communication skills and little active interaction, such as playing games, hugging, patting, or nuzzling, and little nurturing maternal speech toward a baby (Allen & Wasserman, 1985). The result is insecure attachment on the part of a child (Browne & Sagi, 1988; Carlson, Cicchetti, Barnett, & Braunwald, 1989; Crittenden, 1988). The child may be apprehensive in the presence of the parent and may avoid interaction to lessen the chance of hostile responses. Early stimulus–response bonds—an infant’s notion that her or his behavior results in an adult reinforcing response—may be nonexistent, further depressing the child’s behavior. Obviously, this is not an ideal language learning environment. Conclusion Only now are we beginning to understand the effect of caregiver behavior on an infant. Although it seems intuitive that neglect and abuse would cause language and communication problems, especially in language use, the data are only correlational, not cause and effect. Although no practice that harms children can be condoned, professionals must be either mindful of different cultural practices or risk offending or alienating parents (Westby, 2007). By focusing on the welfare of the child, however, it should be easy to recognize when a family has crossed into maltreatment. It may be helpful to think of cultural childrearing practices as falling on a continuum from beneficial to harmful (Koramoa, Lynch, & Kinnair, 2002). Responses by professionals can vary according to where a practice falls on the continuum. Less-than-harmful corporeal punishment, for example, might best be handled by education. Culturally sensitive ways of approaching a family about childrearing and punishment might include the following (Fontes, 2002):

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the laws regarding such practices • Explaining Exploring the goals and suggesting alternative methods • Explaining thefamily’s effects of harsh or corporeal punishment • Gaining the aid of professionals from the same culture • OTH E R LANG UAG E I M PAI R M E NTS Although we’ve touched on some of the more prevalent language impairments, we have by no means exhausted the discussion. I’ve omitted several forms of LI or related conditions for the sake of brevity. Let me at least familiarize you with some category names and brief descriptions. In order, we’ll explore nonspecific language impairment (NLI), late talkers, childhood schizophrenia, selective mutism (SM), otitis media, and children who have received cochlear implants. Disorders specifically related to literacy have been left for discussion in the chapter on literacy impairments. No doubt, your professor will have others to add to the list. Nonspecific Language Impairment (NLI) Children with nonspecific language impairment (NLI) have a general delay in language development, a nonverbal IQ of 86 or lower, and, as in SLI, no obvious sensory or perceptual deficits. Beyond this characterization, the population is poorly described in the disorder literature. Compared to children with SLI, these children perform more poorly on some language tasks and take longer to generalize rule learning (Rice, Tomblin, Hoffman, Richman, & Marquis, 2004). Late Talkers Although a significant number of late-talking children, possibly 40 to 50 percent, have persistent language problems throughout the preschool years, it is difficult to predict the effect of early delay on later development (Dale, Price, Bishop, & Plomin, 2003). Nor is the severity of early delay a good prognostic indicator. By age 4, late talkers without persistent LI do not differ from TD children in morphological development (Rescorla & Roberts, 2002); however, more subtle deficits may be present. Although child health is an important factor in early delay, most early language delay is environmental in origin. Environmental factors persist for children whose parents do not seek professional help such as SLP services (Bishop, Price, Dale, & Plomin, 2003). One environmental factor can be poverty and/or homelessness. Many children in homeless shelters exhibit language delays, but there is no common pattern. In fact, although the majority of both mothers and children in homeless shelters have some type of LI, the lack of a pattern of LI means that they do not form a distinct diagnostic category (O’Neil-Pizozzi, 2003). Childhood Schizophrenia Childhood schizophrenia, a serious psychiatric illness that causes strange thinking, odd feelings, and unusual behavior, is uncommon, occurring in approximately 1 of every 14,000 children below age 13 (APA, 2000). The disorder is difficult to recognize in its early phases, and the cause is unknown; it may result from a combination of brain changes and biochemical, genetic, and environmental factors. Although schizophrenia can be controlled by medical treatment, it is a lifelong disease that cannot be cured at the present time. Symptoms may include seeing and hearing things that are not real, called hallucinating; confusing reality and fantasy; exhibiting odd and eccentric behavior; confused

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thinking and extreme moodiness; and severe anxiety and fearfulness. Behaviors may change slowly over time. Although there are slightly more males than females with the disorder, it is observed only rarely in children below age 5. In general, the earlier the symptoms appear, the poorer the prognosis. Among preschool children, approximately 30 percent who will develop schizophrenia have behaviors similar to those associated with pervasive developmental disorder (PDD) discussed earlier, such as rocking and arm flapping. It is not until early school age or later that children begin to display symptoms of hallucinations, delusions, and disordered thinking. Approximately 55 percent of children and adolescents with schizophrenia have language abnormalities, including language delay (Mental Health Research Association, 2007; Nicolson & Rapoport, 1999). Although there are few studies of the language of children with schizophrenia, data from adults suggest difficulty with pragmatics, especially in content relevancy (Griffin, Crowe, Byrne, & Penzien, 1994; Nicolson, Lenane, Singaracharlu, Malaspina, Giedd, et al., 2000). More specifically, adults have problems with appropriateness of topics and intentions, turn-taking, vocabulary, and nonverbal behaviors (Meilijson, Kasher, & Elizur, 2004). Selective Mutism Selective mutism (SM) is a relatively rare disorder in which a child does not speak in some situations, such as in school, although she or he may speak normally in others. From 0.2 to 0.7 percent of all children may have SM at some time, with girls nearly twice as likely as boys to be affected (Bergman, Piacentini, & McCracken, 2002; Kopp & Gillberg, 1997; Kristensen, 2000; Kumpulainen, Rasanen, Raaska, & Somppi, 1998). Related factors include social anxiety, extreme shyness, and LI or second language learning. Although 30 to 50 percent of children with SM are reported to have LI, the nature and extent of this impairment remains undetermined. Otitis Media Many young children suffer from chronic otitis media. In general, the cumulative effect of recurrent otitis media can be a significant factor in delayed language development (Feldman, Dollaghan, Campbell, Colborn, Janosky, et al., 2003). While otitis media is a factor in LI, children with otitis media do not constitute a separate category. Otitis media may co-occur with categories discussed previously, such as SLI or NLI. Deafness Although limited space precludes discussion of the language of children with deafness, it is important to note the effect of two things, early intervention and cochlear implants. Children born with deafness who receive both speech and sign training in infancy can often become proficient, if not perfect, speakers or develop language through sign, or both. Interestingly, children exposed to sign will express their first word in sign at about 8 months, while hearing children often don’t speak their first word until four months later. Those who receive cochlear implants develop language in a manner similar to that of typically developing children. In general, those implanted as infants show more rapid growth in language than those implanted later; however, the relationship is not simple (Tomblin, Barker, Spencer, Zhang, & Gantz 2005). Although those implanted later have an initial advantage of maturity that enhances lan-

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guage growth, this advantage seems to disappear later as children who received implants at an earlier age begin to develop spoken language at an ever-increasing rate (Ertmer, Strong, & Sadagopan, 2003; Nicholas & Geers, 2007).

Conclusion At this point, most likely, you are in need of a one-sentence summary that once and for all distinguishes each language impairment from the others. Unfortunately, I do not have one forthcoming. Still, one needs to make some sense from the wealth of information presented. At the risk of generalizing too much, let’s try. At the beginning of the chapter, I cited six abilities needed for typical language development. It might be helpful to consider these in conceptualizing the language impairments discussed (see Table 2.14). Perceptual difficulties are reported for some of the disorders mentioned, but not all. Nor are they similar in type and severity. For children with SLI, perceptual difficulties seem to be limited to rapid, sequenced auditory stimuli, but perceptual difficulties are the essence of LLD and ASD. Even here the difference seems to be one of perception and sensory integration in LLD and threshold levels in ASD. Attentional difficulties also accompany several of the language impairments discussed. Again the variability is great. Children with ASD are either seemingly inattentive or fixated on one, often irrelevant, aspect of a stimulus. In contrast, children with TBI experience attentional fluctuations and seem to attend for only brief periods. Although all children with language impairment have difficulty using symbols, this difficulty varies. Children with ID and ASD have great difficulty with symbol referent relationships, while those who are neglected and abused have little difficulty with language form and content.

TABLE 2.14 Language Learning Requirements and the Difficulties of Children with Language Impairment* Language Impairment

Requirements

ID

Ability to perceive sequenced acoustic events of short duration Ability to attend actively, to be responsive, and to anticipate stimuli

LLD

SLI

ASD

TBI

X*

X

X

X

X

X

Ability to use symbols

X

X

X

X

X

Ability to invent syntax from the language in the environment

X

X

X

X

Enough mental energy to do all the above simultaneously

X

Ability to interact and communicate with others *Xs represent problem areas in language learning and use.

X

X

X X

Neglect/ Abuse

X

X X

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Language is rarely taught formally. Instead, children acquire language by hypothesizing the rules from the give-and-take of conversational speech. This can be a difficult task if the child is inattentive or has difficulty perceiving language, as are children with LLD, ASD, and TBI. The requirement of having enough mental energy is a tricky one. We shall broaden the concept somewhat. Children with ID may lack the mental abilities for some tasks, while those with SLI and TBI may use vital mental energy on lower level tasks, leaving little for language analysis and synthesis. The frequently reported depression of children with TBI and children who are neglected and abused also limits the cognitive energy available for language learning. Finally, the ability to interact and communicate with others probably is affected in each of the disorders discussed. The difficulty is in determining whether an inability to interact and communicate reflects a cause of the impairment, a result, both, or just an accompanying feature. Among at least two groups of children—those with ASD and those who are neglected and abused—inability to interact seems directly related to the language impairment exhibited. Each impairment presents a somewhat different image. In a clinical sense, however, the important features to which a SLP attends are the individual characteristics of each child, not the diagnostic category. Naming and describing a language impairment does not necessarily explain it nor determine clinical intervention. I M PLICATIONS Language impairments are not outgrown. Even with intervention, they are rarely “cured.” Typically, language impairments change and become more subtle (Wallach & Liebergott, 1984). Children with preschool LI may continue to have trouble with linguistic and academic tasks. Language impairments in kindergarten are likely to persist well into elementary school (Tomblin, Zhang, Buckwalter, & O’Brien, 2003). Reading performance may be affected (Hill & Haynes, 1992). As adults, children with LI may continue to do poorly in speech and language although nonlinguistic skills seem unaffected (Felsenfeld, Broen, & McCue, 1992). With or without intervention, certain ramifications of having an LI affect academic performance and social acceptance. Poor oral language usually results in poor reading and writing ability. It has been hypothesized that poor reading reflects the child’s lack of language awareness skills, called metalinguistic abilities (Menyuk, Chesnick, Liebergott, Korngold, D’Agostino, et al., 1991). For example, a child may be unaware of syllable or phonetic segmentation of words. This awareness is crucial for reading. Lack of these higher level language skills may explain the poor reading performance of children with SLI. Within the classroom, children with LI form a separate subgroup that interacts increasingly less with their peers developing typically (Guralnick, 1990; Hadley & Rice, 1991). One’s relative communication skills influence participation. Because children with LI are poor communicators overall (Fey, 1986), they are increasingly ignored. As a result, children with LI are more likely to be overidentified as having a socioemotional disorder (Redmond, 2002). In general, children with LI exhibit more behavior problems and poorer social skills than do their TD peers (Qi & Kaiser, 2004). The poor ability of these children to infer emotional reactions in social situation may contribute to the social difficulties they encounter (Ford & Milosky, 2003). Teachers rate children with LI significantly below their peers in impulse control, likability, and social behaviors such as helping others, offering comfort, and sharing (Fujiki, Brinton, Morgan, & Hart, 1999). Increasing reticence to talk leads to withdrawal, especially among prepubescent and adolescent boys (Fujiki, Brinton, Isaacson, & Summers, 2001).

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In general, a child’s popularity is associated with her or his conversational skills (Hazen & Black, 1989). Children with LI initiate little verbal interaction, are less responsive, use more short and nonverbal responses, and are less able to maintain a conversation (Rice, Snell, & Hadley, 1991). The result is fewer interactions with others (Hadley & Rice, 1991). Children with LI often continue to have poor vocabularies and poor higher level semantic skills. These include difficulties with abstract meanings, figurative language, dual meanings, ambiguity, and humor (Donahue & Bryan, 1984; Kamhi, 1987; Nippold, 1985; Spector, 1990; Wiig & Semel, 1984). Syntax and morphology are usually characterized by the continued use of less mature forms (Curtiss, Kutz, & Tallal, 1992; Leonard, 1987, 1988). Word formation processes, consisting of a free morpheme plus one or more bound morphemes, are less mature (Clahsen, 1989; Leonard, Sabbadini, Leonard, & Volterra, 1987; Leonard, Sabbadini, Volterra, & Leonard, 1988; Rom & Leonard, 1990). Similarly, phonological patterns usually reflect those of younger children (Ingram, 1991; Shriberg, Kwiatkowski, Best, Hengst, & Terselic-Weber, 1986). Finally, language comprehension difficulties, especially at higher levels such as detection of ambiguity, may persist. These difficulties reflect the underlying language difficulties evidenced in expressive language (Skarakis-Doyle & Mullin, 1990). SLPs are responsible for intervening to correct some language difficulties, to modify others, and to teach compensation skills for still others. In the chapters that follow, we explore a model that proposes to do this in the most natural way possible.

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2 part

Communication Assessment C H A PTE R 3

Assessment of Preschool and School-Age Children with Language Impairment C H A PTE R 4

Assessment of Preschool and School-Age Children with Language Difference C H A PTE R 5

Language Sampling C H A PTE R 6

Analysis Across Utterances and Partners and by Communication Event C H A PTE R 7

Analyzing a Language Sample at the Utterance Level C H A PTE R 8

Narrative Analysis

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Communication Assessment

till feeling overwhelmed by the list of possible disorders associated with LI? Here’s some comfort. First, as an SLP, you won’t be solely responsible for designating a child as one thing or another. You’ll be on a team with other knowledgeable professionals, although you’ll bring your own respected expertise. Ideally, your team will conduct a thorough assessment, weigh all the information, and make thoughtful and appropriate recommendations for intervention. Second, as you acquire more experience and become more skilled, you’ll learn to recognize patterns of behavior and signs that indicate the presence or certain underlying disorders. These patterns may not seem so obvious now. In the last analysis, however, nothing is a substitute for the data you systematically gather through an individualized, well-designed, thorough assessment of a child’s communication skills and deficits. No clear line exists between assessment and intervention. Both are part of the intervention process, and portions of each are found in the other. Ideally, assessment and measurement are ongoing throughout intervention. No clinical goal should be determined or modified without first obtaining data on the communication performance of a child. Adequate evaluation is one of the most difficult and demanding tasks faced by an SLP. The goal— much more complex than providing a score or a diagnostic label—is to describe the very complex language system of each child. Each has a unique pattern of language rules and behaviors to be revealed and described. As an SLP, keep in mind the why, what, and how of assessment. Considering why a child is being assessed helps you clarify the purpose of the assessment. This clarity, in turn, enables you to decide what specific behaviors to assess and the best evaluative methods to use. The reasons for assessment can be grouped as (a) identification of children with potential problems, (b) establishment of baseline functioning, and (c) measurement of change. Baseline functioning enables an SLP to determine the present level of performance, the extent of the language impairment, and the nature of the problem. The data-gathering process is scientific in nature in that it must be unbiased and objective. This collection process should be precise and measurable, with very little intrusion by an SLP’s premature conclusions. It is important, however, not to lose the child in the mass of data you’ll collect, and clinical intuition is an important factor when summarizing data and determining which aspects of language to evaluate. It may be helpful to consider assessment procedures as existing along a continuum from formal, structured protocols to informal, less structured approaches. In general, the more structured the elicitation session, the less variety of structures and meanings expressed. Language elicited in more structured tasks is usually shorter and less complex, especially with younger children, than language sampled in less controlled situations (Fey, Leonard, & Wilcox, 1981). Generally, the more specific the information desired, the more structured the approach. In this way, assessment procedures can help an SLP sharpen and focus what observed. Even formal tests or portions of tests can be used in an informal way as a probe of specific behavior. More on this later. In this chapter, we explore the differences between psychometric and descriptive assessment paradigms and describe a combined, or integrative, approach that attempts systematically to address the shortcomings of both approaches while describing a child’s use of language in context. After discussing the integrated approach and applying it to more typical language impairment cases, we’ll discuss some of the special needs of children with LI.

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Psychometric Versus Descriptive Procedures The goals of communication assessment are to identify and describe each child’s unique pattern of communication behaviors and, if that pattern signifies a language impairment, to recommend treatment, follow-up, or referral. Through this process, an SLP determines a problem exists. • Whether The causal-related factors. • The overall intervention plan. • There are two major philosophical approaches to this task. The normalist philosophy is based on a norm, or average performance level—usually a score—that society considers typical of normal functioning. In contrast, the neutralist, or criterion-referenced, approach compares a child’s present performance to past performance and/or is descriptive in manner. The features of each approach are presented in Table 3.1. The two methods are really modes of interpreting measurable behavior and are not mutually exclusive (McCauley, 1996). For example, the results of testing can be reinterpreted to provide more descriptive information, including categories of behavior not included in the test and success with different formats (Olswang & Bain, 1996). Test items on which a child is unsuccessful can be probed to determine other methods that result in a correct response. Tests are usually standardized and normed. Standardized means that there is a consistent manner in which test items are to be presented and child responses consequated. For example, the test manual may direct an SLP to give the following instructions: I am going to read a sentence to you. When I’m finished, I want you to select the picture that best illustrates what I have said. Listen carefully, because I can only read each sentence once. The test is to be administed in this manner. Most standardized tests are also normed, which means that the test has been given to a group of children that supposedly represent all children for whom the test was designed and scores determined for typical functioning. Ideally, the norming group has the same characteristics as the children for whom it’s designed. In other words, gender, racial and ethnic, TABLE 3.1

Comparison of Norm Referencing and Criterion Referencing

Norm Referencing

Criterion Referencing

Fundamental purpose is to rank individuals.

Fundamental purpose is to distinguish specific levels of performance.

Test planning addresses a broad content.

Test planning addresses a clearly specified domain.

Items are chosen to distinguish among individuals.

Items are chosen to cover content domain.

Performance can be summarized meaningfully using percentile or standard scores.

Performance can be summarized meaningfully using raw scores.

Source: Reprinted with permission from Familiar strangers: Criterion-referenced measurements in communication disorders by R. J. McCauley. Language, Speech, and Hearing Services in Schools, 27, 122–131. Copyright © 1996 by American Speech-Language-Hearing Association. All rights reserved.

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geographic, and socioeconomic differences present in your children are also represented in the norming group in the same proportions. Even these constraints do not ensure that the test will be appropriate, especially with children from culturally and linguistically diverse backgrounds. Usually, children with LI are rarely included in the norming group. This may surprise you. Traditional language assessment procedures heavily emphasize the use of standardized psychometric or norm-referenced tests. This situation is reflected in the fact that more than 100 norm-referenced language assessment tools are commercially available. In general, there are very few standardized measures for toddlers and adolescents and an abundance of measures for preschoolers and early-schoolage children. Ideally, a standardized test has been given to a large number of children from various populations, has demonstrated reliability and validity, and has normative data that provide scale score, age equivalent, or numerical score comparisons. Reliability is the repeatability of measurement. More precisely, reliability is the accuracy or precision with which a sample of language taken at one time represents performance of either a different but similar sample or the same sample at a different time. Factors that may affect reliability include individual change over time, sample differences, and the nature of the language sample in size or inclusiveness. Very limited samples of language usually result in unstable or undependable scores. Thus, a test must include enough language to be reliable yet not unwieldy. Add to these concerns the great difficulty in obtaining consistent performance from children, and the chance of producing a reliable measure decreases. Test makers and users are concerned with both internal consistency and various measures of reliability. Internal consistency is the degree of relationship among items and the overall test. If a test has high internal consistency, children who score well overall should tend to get the same items correct, whereas those who score low should tend to perform similarly among themselves. Measures of reliability include test-retest reliability, alternate-form reliability, and split-half reliability. In test-retest reliability, a child is administered the same test with a time interval between each administration. With alternate forms, a child is administered equivalent or parallel forms of a measure. Finally, a test may be divided into equivalent halves. In each case, the two test scores are compared and the consistency of scores measured. This value is expressed as a reliability coefficient or as a standard error of measure (SEm). The closer the reliability coefficient to a value of 1 and the lower the standard error, the more reliable is the measure. In other words, a reliability coefficient of .84 indicates greater reliability than one of .62. SEm will be discussed in more detail later. In addition, an SLP is concerned with the probability of two judges scoring the same behavior in the same manner. This value is called interjudge reliability. As a group, scoring procedures that use a definite criterion, such as accepting only specific responses as correct, are more reliable than those that use scaled scoring, such as grading responses (1–5) by their degree of correctness. Graded scores can have increased reliability if each score has definite criteria or if the tester has received specific training. Validity is the effectiveness of a test in representing, describing, or predicting an attribute of interest to the tester. In short, it is a measure of the test’s ability to assess what it purports to assess. The tester is interested in measuring all of the attribute being tested but nothing other than that attribute. For example, if a test of receptive language abilities requires a child to respond verbally, it goes beyond the stated domain of the attribute being tested. Professionals should be cautious when choosing tests. Few language screening tests, for example, meet criteria for validity or provide information to enable SLPs to determine validity (Sturner, Layton, Evans, Heller, Funk, & Machon, 1994).

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To test an abstract concept such as intelligence, test designers must select concrete tasks (Kamhi, 1993). These tasks, in turn, often become the defining features of the abstract entity supposedly measured. For example, intelligence becomes the sum of the test tasks when it is clearly much more. Tests do not represent the overall attribute or behavior but are merely samples. From the samples, testers make inferences about the overall attribute or behavior. If the samples are not valid measures, the inferences will be incorrect. Validity is not self-evident and must be proven. Three types of evidence are criterion validity, content validity, and construct validity. Criterion validity is the effectiveness or accuracy with which a measure predicts success. This usually is calculated as the degree to which a measure correlates with some other suitable measures of success assumed to be valid. Content validity is the faithfulness with which the sample or measure represents some attribute or behavior. In other words, the sum of the tasks involved should define or constitute, at least in part, the attribute or behavior being measured. Measures should reflect the professional literature, research, and expert opinion on the constitution of the attribute or behavior tested. Finally, construct validity is the extent to which a measure describes or measures some trait or construct. Professionals are interested in the significance of results and in how precisely the measure notes individual or group differences. Construct validity usually is determined by comparing the measure with other acceptable measures assumed to be valid. One study found that one-third of the kindergartners who failed one of two language screening tests passed the other, possibly indicating that the tests assessed different aspects of language (Summers, Larson, Miguel, & Terrell, 1996). Tests, or measures, help the SLP determine how a child’s performance, in the form of a score, compares with that of children who supposedly possess the same characteristics (McCauley & Swisher, 1984a, 1984b). Most frequently, tests are used to determine average and less-than-average performance for decisions about the need for intervention services (Lund & Duchan, 1993). Unfortunately, many traditional assessment procedures do not reflect current definitions of the nature of language (Ray, 1989). Although normative tests may be good for measuring isolated skills, they provide very little information on overall language use. More descriptive approaches, such as language sampling, can highlight the individualistic nature of a child’s communicative functioning. In contrast, psychometric normative testing imposes group criteria on an individual, thereby obviating an assessment of the individual. Each method of assessment has its strengths and weaknesses, as well as possible applications within the clinical setting. These are described in the following sections.

Psychometric Assessment Protocols Ideally, a test elicits a standard and representative sample of a behavior. A test is normed by using specified explicit procedures and administering the test to a sample from a specific population, such as all English-speaking first graders in the United States. Normed tests enable an SLP to compare individual performance with that of a larger population. In general, norm-referenced assessment tools have the advantages of objectivity, replicability, and elimination of unwanted or uncontrolled variation. Tests are particularly helpful when deciding whether a problem exists. Although normed tests are potentially valid, reliable, and precise in measurement, it is difficult to find a language test that is acceptable in all three ways. In addition, normed tests do not easily accommodate cultural and individual variation, nor do they begin to provide a true picture of the richness

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and complexity of the child’s communication behavior. In other words, “at their best ... tests provide an unclear picture of communication performance” (L. Miller, 1993, p. 13). By their nature, tests are less complex than the language being assessed (Ray, 1989). Language is multidimensional and its use individualistic, making it difficult to measure (Damico, 1988). Most SLPs are either neutral or negative toward existing language tests. School-based SLPs are more negative. The main concerns seem to be the length of time needed for administration and interpretation and the inadequacy of most tests for use with multicultural populations (Huang, Hopkins, & Nippold, 1997). TEST DI FFE R E NCES Language assessment instruments differ widely even when purported to measure the same entity. Even tests that seem to be significantly correlated, suggesting an interrelationship, may seem less so when subtests or various portions of tests are compared. Nor does positive correlation mean that tests are acceptable substitutions for each other (Friend & Channell, 1987). In addition, tests can differ markedly in their levels of difficulty (Lieberman, Heffron, West, Hutchinson, & Swem, 1987). Task variability, or the way in which something is tested, is also a big factor and can affect test results, yielding different results for the same child for the same skill (Fagundes, Haynes, Haak, & Moran, 1998). All tests are not created equal and should be researched carefully by SLPs before being used. In the following section we explore some of these differences, specifically test content, and some of the common misuses of tests. Finally, the variables that should be considered in test selection are discussed. CONTE NT The major criticism of existing instruments is the inadequacy of the content covered in both breadth and depth. Two issues relative to content validity—relevance and coverage—must be addressed in test construction. Content relevance is the precision with which a certain aspect of language is delineated or defined. This is necessary to determine the dimensions of that aspect to test. The issue of content relevance is made more complicated by our lack of an agreed definition of language (Lahey, 1990). In addition, a child’s knowledge of language, called competence, is measurable only as behavior or performance, which is affected by contextual variables, such as speed and complexity. Thus, poor performance may indicate an underlying deficit or difficulty with the assessment procedure, or the test content. Content coverage is the representativeness with which an aspect of language is sampled. Theoretically, coverage of language features should reflect general use. Some features may be more significant than others; however, this fact can be verified only through statistical analysis. Otherwise, subtle language impairments may go undetected. A single test’s rather limited sample of a child’s skills is an inadequate base on which to build a sound remedial program (Lieberman & Michael, 1986). The psychometric testing model produces data on minimal portions of behavior, thus reducing language to simple, possibly irrelevant dimensions that may not reflect the qualities of that language overall (Kamhi, 1993). By fragmenting language into observable and measurable features, tests may highlight skills only tangentially related to language ability. Tests tend to emphasize structural components of language because they are easy to observe. Although structured testing may reveal the child’s ability to use language in one context, it reveals very little about the child’s language as it is needed and used in everyday communication.

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In addition, language use in an isolated test situation may bear little resemblance to language use in everyday contexts (Newman, Lovett, & Dennis, 1986). For example, a child may use interrogatives throughout the day to obtain information, desired objects, and needed assistance but may be unable to form interrogatives in isolation when given a group of words to include. In addition, the test situation may be so foreign to a child or that child’s everyday communication environment that it influences the language the child produces. Performance may be affected also by factors as diverse as a child’s state of health on the day the test is administered, attention level and comprehension of the instructions, and perception of the test administrator. In short, norm-referenced approaches offer “canned” assessment with little consideration for the individual needs of the child with whom they are used. The tendency is for assessment procedures to take priority over the child, especially when test selection is based on commercial availability or clinical popularity (Duchan, 1982a; Kamhi, 1984). Tests are a priori and product oriented, offering little information on the appropriateness of the features being tested. Test results, in turn, offer little assistance in identifying individual problems and in planning intervention. M ISUSE OF NOR MATIVE TESTI NG Norm-referenced tests should be used with caution. The best advice is to be an “informed clinician” and a wise consumer. SLPs should be mindful of the frequent misuse of these instruments (Lieberman & Michael, 1986; Stephens & Montgomery, 1985), among them (a) misuse of scores as a summary of a child’s performance, (b) use of inappropriate norms, (c) inappropriate assumptions based on test results, (d) use of specific test items to plan intervention goals, and (e) use of tests to assess therapy progress. Let’s discuss each briefly. Misuse of Scores When does difference become disorder? We should remind ourselves that the 1 percent of the population who are blood type B-negative is not considered deviant, just different (L. Miller, 1993). So how do we decide? The most frequently used score on standardized measures is the mean, or average, score. Test makers assume that the average score for a sample population is the “normal” score for the larger population. When plotted, the total number of individuals receiving each score will form the familiar bell-shaped curve, represented in Figure 3.1. It is important to recall that a wide scoring area about the mean, called one standard deviation, also is considered to fall within the normal range. Approximately two-thirds of the population will score within 1 standard deviation on either side of the mean score. An SLP must decide where “nonnormal” or disorder occurs. If she uses only 1 standard deviation for separating normal from nonnormal, she will find that nearly one-third of the population, approximately 16 percent above and 16 percent below, fails to fall within this range. Two standard deviations is a better index of deviancy, leaving approximately 3 percent of the population above and 3 percent below those within the normal range. A second index is the 10th percentile, the lowest 10 percent of the norming sample. Children who score at or below the 10th percentile are often considered to be other-than-normal. Scores at either end of the distribution represent a quantitative difference that can be called disordered, exceptional, or impaired. Obviously, our boundary of 2 standard deviations is relative. The SLP must decide when the difference is so great as to impair an individual.

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X

Frequency

76

1 Standard Deviation

Scores

Scores X 2 Standard Deviations

FIGURE 3.1 Parameters of the normal distribution.

The use of scores imposes some constraints that many professionals overlook. First, numbers establish equalities and inequalities. For example, 2 is twice 1 and half of 4. It would seem, therefore, that a child with a score of 4 correct has twice the skill of one with a score of 2, but this is a measure of the number of responses, not their quality. Second, all test items are assumed to be equal because each has the same weight (L. Miller, 1993). If there is one item each for the verb to be and past-tense -ed, they each receive the same score even though they are not of equal importance developmentally. Beyond concerns about numerical equalities-inequalities, an SLP must consider the standards for comparison of children, such as chronological, mental, or language age. For example, it seems inappropriate in most cases to give a diagnostic test designed for 6-year-olds to a 6-year-old child with ID who is functioning at age 3 unless our goal is to confirm that the child is in fact retarded. Scores imply some standard of performance when in fact there may be none, except the numerical score. The use of age-equivalent scores—the average or projected age of children getting a certain number of items correct—for example, can lead to erroneous assumptions about children’s behavior. The equality of scores does not translate to an equality of behavior and offers an inadequate description of that individualistic behavior. A child who achieves the same score as a younger child may not make the same kinds of errors (Lawrence, 1992). Two children with the same scores could have answered very different items correctly. Speech-language pathologists habitually should check the standard error of measure (SEm) for information about the confidence of test scores (J. Brown, 1989). Because tests are less than perfectly reliable, a certain amount of error is reflected in each score. The larger the SEm, the less confidence one can have in the test’s results. The SEm can be added to and subtracted from a test score to establish a band of confidence. For example, assume that a child received a score of 75 on two different tests with confidence intervals of 2 and 6, respectively. On the first test, the child’s error-free, or true, score is most probably 73–77; on

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74 75 76 77 78 79 80 81 82 83 84 85 86 87 88 89 90 91 92 93 94 95 96 97 A

B

SEm = ± 6 SEm = ± 6 Overlap FIGURE 3.2

A comparison of scores using standard error of measure.

the second, it is 69–81. The SLP can have more confidence that the score of 75 on the first test is closer to the child’s actual performance. Larger SEm values also may mean that scores that seem very different actually overlap, as shown in Figure 3.2. Child A received a score of 81, and Child B received a score of 90. An SEm of 6 applied to each score results in an overlap. Therefore, the children’s actual abilities may be much more similar than the test scores alone indicate. An SLP should check the test manual to obtain the SEm. Because this information is not always available, the SLP may wish to determine this value from Table 3.2 (J. Brown, 1989). The entering values of standard deviation and reliability coefficient usually are provided in the test manual. Quantification or scoring of behaviors is not inherently bad. Measurement should be meaningful and functional and should reflect accurately the entity being evaluated (Kamhi, 1993). It is important that test designers define the entities being tested and provide a rationale in the test manual for the tasks selected. SLPs should read, understand, and evaluate the manual accompanying the test and be knowledgeable about test construction and administration (Stephens & Montgomery, 1985). Evidence-based practice requires that the professional literature about a certain test be studied thoroughly before the test is used. Inappropriate Norms Often, the norming sample does not represent the population with which an SLP is using the test (Lahey, 1990). In this situation, the norms are inappropriate and should not be used. This situation occurs most frequently with minority or rural children or with children from lower socioeconomic groups. In these cases, local norms should be prepared by an SLP by following the norming procedure described in the test manual. Some test manuals, such as those for the Test of Language Development–Intermediate (TOLD-I) and the CELF, explain this process in detail. Finally, we cannot assume that norms are stable. They change over time. In addition, changes in the format of the test, such as offering it on computer, also change the norms. Separate norms are needed when a test is offered in a computerized format (Wiig, Jones, & Wiig, 1996). If a test is given in an other-than-standardized manner, resultant scores should not be compared to the test’s norms. There may be occasions when administration procedures need to be minimally modified, such as allowing a child with cerebral palsy to use a head pointer rather than pointing by hand, and it is your clinical judgment that the changes are nonsignificant. If you use the norms, however, you should state in your report that an alternative method was used.

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TABLE 3.2 Table of Standard Error of Measure Reliability and Standard Deviation Values to Estimate the Standard Error of Measure (SEm) Reliability Coefficient Standard Deviation

30 28 26 24 22 20 18 16 14 12 10 8 6 4 2

[Tch03tabel02]

.95

.90

.85

.80

.75

.70

.65

.60

.55

6.7 6.3 5.8 5.4 4.9 4.5 4.0 3.6 3.1 2.7 2.2 1.8 1.3 .9 .4

9.5 8.9 8.2 7.6 7.0 6.3 5.7 5.1 4.4 3.8 3.2 2.5 1.9 1.3 .6

11.6 10.8 10.1 9.3 8.5 7.7 7.0 6.2 5.4 4.6 3.9 3.1 2.3 1.5 .8

13.4 12.5 11.6 10.7 9.8 8.9 8.0 7.2 6.3 5.4 4.5 3.6 2.7 1.8 .9

15.0 14.0 13.0 12.0 11.0 10.0 9.0 8.0 7.0 6.0 5.0 4.0 3.0 2.0 1.0

16.4 15.3 14.2 13.1 12.0 11.0 9.9 8.8 7.7 6.6 5.5 4.4 3.3 2.2 1.1

17.7 16.6 15.4 14.2 13.0 11.8 10.6 9.5 8.3 7.1 5.9 4.7 3.6 2.4 1.2

19.0 17.7 16.4 15.2 13.9 12.7 11.4 10.1 8.9 7.6 6.3 5.1 3.8 2.5 1.3

20.1 18.8 17.4 16.1 14.8 13.4 12.1 10.7 9.4 8.0 6.7 5.4 4.0 2.7 1.3

Note: This table of standard error of measurement is based on the formula SEm = SD 1 − r11 where SD is the standard deviation of the test scores and r11 is the reliability coefficient for internal consistency of the test scores. Source: Reprinted with permission from The truth about scores children achieve on tests by J. Brown. Language, Speech, and Hearing Services in Schools, 20, 366–371. Copyright © 1989 by American Speech-LanguageHearing Association. All rights reserved.

Incorrect Assumptions Test scores may represent only scores and not actual differences in linguistic ability. Therefore, an SLP must analyze each child’s performance in order to obtain descriptive information. For example, subtest scores can be interpreted independently from each other. An SLP also should be cautious in extrapolating global language development from scores on language tests, especially those that sample only one or two aspects of language. The Peabody Picture Vocabulary Test (PPVT) is an excellent receptive vocabulary test, but it does not address other aspects of language or indicate overall language use. Identifying Intervention Goals A thorough description of a child’s behavior is needed before an SLP can identify areas needing intervention. Individual test items or subtests do not provide an adequate sample of that behavior. Because test items represent only a small portion of language, they do not provide enough information on which to base therapy goals. At the very least, more than one psychometric assessment procedure

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should be used because of the variability of some children across tests (Stephens & Montgomery, 1985). The more test scores available, the more reliable the assessment. Only through the use of a number of assessment protocols can the SLP hope to determine intervention objectives (Lahey, 1990). Psychometric tests should be only a portion of the assessment process. Measuring Therapy Progress The continued use of a norm-referenced test to assess therapy progress may result in a child’s learning the test, thus producing artificially high results. However, widely spaced testing or the use of different forms of the same test or of different but highly correlated tests can demonstrate changes in behavior over time (McCauley & Swisher, 1984b). Just remember that all test items are not equal. A child whose score has changed little may have made more progress than another child whose score has changed more. Criterion-referenced tests, explained later in the chapter, are more appropriate for measuring individual progress. VAR IAB LES I N TEST SE LECTION An SLP should be a wise consumer of assessment materials and should base test selection on several factors. Of particular interest are test reliability and validity, discussed previously. Even language tests that meet very stringent psychometric or measurement criteria may not be very precise discriminators of impaired and nonimpaired language (Plante & Vance, 1994). Other considerations in test selection include appropriateness of the test for a particular child, the manner of presentation and comprehensiveness, and the type and sensitivity of the test results. A test should be appropriate to the child’s age or functioning level. In addition, the norming population should be sufficiently large and varied to include representatives of the child’s racioethnic and socioeconomic background. If the child is from an identifiable minority, the SLP should check to see whether the norming information gives data by such groups. Appropriateness may relate also to manner of presentation, which usually reflects the overall theoretical basis of the test. A sentence imitation test, for example, relies on auditory processing of verbal stimuli, rather than on picture cues. Other practical issues related to presentation include the number of items and the content coverage discussed previously. Some children perform better under certain conditions than under others. For example, children with LLD can perform better if visual input accompanies the verbal. Some tests offer a computerized version for children with motoric problems or those who may perform better on this format. Results of computerized test formats seem to be equivalent to those from the standard form of administration, but this will vary across children (Haaf, Duncan, Skarakis-Doyle, Carew, & Kapitan, 1999). The type of result, whether percentage, percentile, or age equivalent, is also a practical consideration in test selection. Depending on the test, the interpretive value of such scores may be very limited. When given a choice of different tests, SLPs display a remarkable similarity in the relative importance they attach to different measures (Records & Tomblin, 1994). Receptive measures, such as the Test of Auditory Comprehension of Language (TACL) and the PPVT are relied on heavily. Sentence imitation and grammatical closure tasks in which a child fills in a blank also are preferred. Familiarity with the test procedure, overall opinion of the measure, and clinical experience are all factors in test or task selection and in the relative importance attached to data obtained from different measures.

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SU M MARY Perceptive professionals decry overdependence on and poor interpretation of the results of testing. Although standardized tests, especially those in language, frequently have been maligned, SLPs often are required to incorporate the results of these procedures into their overall assessments. It is important for SLPs to recognize that tests are informative, but not the be-all and end-all of evaluation. Awareness of a test’s shortcomings can greatly aid the interpretation of a child’s performance (Stephens & Montgomery, 1985). The issue of testing is central to the purpose of assessment. Data gathered in an assessment should be relevant to the initial clinical complaint, to the determination that a problem exists, to individual differences and individual processing, to the nature of the problem, to prognosis, to intervention implications, and to accountability (Muma, 1986). Otherwise, it is just a numbers game. Although normreferenced tests seem appropriate for determining if a language impairment exists, they are inconsistent in determining the specific area(s) of deficit (Merrell & Plante, 1997).

Descriptive Approaches The descriptive approach, usually based on observation and a conversational sample of a child’s language, is a widely taught method of defining children’s communicative abilities. Unfortunately, because of time constraints the method is not widely used, but it continues to gain favor. Descriptive approaches have the potential of allowing SLPs to regard the language process while maintaining contextual integrity and individual differences (Muma, 1986). Spontaneous sampling alone is best used as an indicator of a child’s overall language functioning rather than as a device for noting specific language problems. More specific data can be obtained by probing the child’s conversational behavior. In general, data from a language sample correlate significantly with results from elicited imitation and sentence completion tasks; however, the syntactic structural patterns vary widely (Fujiki & Willbrand, 1982). The advantages of the descriptive approach are that an SLP can apply his or her own theoretical model to the assessment process and can probe and assess areas that seem most handicapping to a child. For example, an SLP who follows a sociolinguistic model of language is free to explore the pragmatic and conversational aspects of a child’s language. Thus, the clinical process can remain flexible and attuned to the client’s needs (Kamhi, 1984). To do this, an SLP must understand the complex interaction of constitutional—biological, cognitive, psychological, and social—and environmental forces. A speech sample has several advantages over more formal structured-response testing, which reveals little about the use, content, and form of a child’s language as needed and used in daily living. For example, single-word responses on a test may not be as adequate a database for analysis as a longer conversational response might be. Some language features are more sensitive to the linguistic and extralinguistic factors of conversational give-and-take (McLeod, Hand, Rosenthal, & Hayes, 1994). The disadvantages of the descriptive approach are (a) the level of language expertise needed by an SLP in order to elicit and analyze a child’s language, (b) the length of time needed to collect and analyze the child’s language, and (c) the reliability and validity of the sample (Kelly & Rice, 1986). Although a number of descriptive protocols exist, an SLP may not feel sufficiently well versed in all aspects of language to choose those appropriate for each child. For example, many theoreticians place great value in the pragmatic functions of each utterance. Yet, an SLP may not be comfortable with the pragmatic

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aspects of language. In addition, a large caseload may preclude the use of lengthy descriptive procedures. Finally, as in psychometric testing, the SLP may not elicit a reliable or valid sample of a child’s usual language usage. R E LIAB I LITY AN D VALI DITY Language samples are more susceptible than standardized measures to SLP bias, especially when used to assess intervention effectiveness (Nye et al., 1987). An SLP must attempt to analyze the language sample in the most objective manner possible. Objective descriptions of the actual behaviors observed are generally more reliable than subjective judgments of the causes or reasons for these behaviors. One way to increase reliability is to separate the actual events from inferences based on these events and to base decisions on the data from these events. Reliability across observations can be increased by taking the following three precautions: 1. Define the behaviors to be observed as explicitly as possible, and train observers to ensure good inter- and intraobserver reliability. The selection of behavior categories to be observed will affect the validity of the observation. For example, it may be easier and more accurate to identify certain gestures than to record verbal intentions. Accuracy can be controlled by making comparisons between the ratings of two observers. This type of analysis helps sharpen definitions and to highlight possible areas of confusion. 2. Make judgments on only one type of behavior at a time. This procedure may require the use of videotaping or digital recording so that a language sample can be replayed often for additional judgments on other behaviors. 3. Do not make summation judgments while observing “on-line.” It is too easy for preconceived notions of the child to influence our interpretation. Judgments about overall behavior are best made after assessing the accumulated data. There is danger in attempting to fit the child into one of the language impairment categories mentioned in Chapter 2. Some threats to validity are found within the sample itself. For example, preschool children vary in their attentiveness and disposition to talk moment by moment. Given this condition, the possible threats to validity in a speech sample, even with older children, are productivity, or the amount produced; intelligibility, or the amount understood by the listener; representativeness, or the typicality of the sample; and reactivity, or the response of the child to differing stimuli (Shriberg & Kwiatkowski, 1985). Productivity The uncommunicative child or the child who says very little will not give an SLP a productive sample from which to work even though such a sample may reflect accurately the child’s typical output. The child may have little language with which to talk. The key to greater production is for the SLP to plan a variety of elicitation tasks that serve the purpose of gathering the sample (Wren, 1985). Intelligibility Intelligibility is the amount of agreement between what a child intended to say and what the SLP interpreted from the sample. If much of the sample is unintelligible, few utterances will be suitable for

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analysis. In general, intelligibility can be increased with increased SLP control over the content of the child’s utterances. In short, the SLP who knows the topic can determine more easily what the child said. Representativeness A sample may not represent a child’s typical behavior. Language samples often are collected in an atypical context, for example, a clinical room with an unfamiliar SLP as the conversational partner. Much of the sample may be atypical when removed from a child’s typical conversational context (Roth & Spekman, 1984b). Three issues are relative to the representativeness of the conversational sample: spontaneity, variability of context, and stability of the structure/function sampled (Muma, 1983). Spontaneity is increased if the child is allowed to establish the topic and/or the activity. Interesting and varied stimulus materials can provide an excellent basis for spontaneous conversation and can elicit a variety of forms and functions. Variability of the context and stimulus items will elicit a greater variety of child behaviors theoretically more representative of the child’s everyday behavior. Data should be collected in a variety of settings, with a variety of partners, and on a variety of child-based conversational topics to ensure versatility. Because quantity and complexity vary with the task, no individual task is likely to yield a representative sample of a child’s language (Wren, 1985). Unrepresentative samples may reflect other-than-normal usage by a child. In this situation, the structures or functions sampled may vary widely from one situation to another. Everyday situations are most likely to elicit typical use and thus provide some stability across situations. Some discussion has concerned whether SLPs should try to elicit typical or maximum production from a child. This debate is fueled by the often-reported gaps between what children with LI are capable of doing with their language and what they typically do. An SLP must decide on the appropriate task to use. For example, storytelling tasks yield longer utterances, while picture interpretation tasks elicit greater language quantity. Various elicitation tasks will be discussed in detail later. Reactivity A child’s reaction to the techniques and the materials also will affect the overall validity of the sample produced. Sampling conditions and the nature of the content or stimuli available can greatly affect the sample. A directed condition, such as one in which an SLP uses a questioning technique, allows the examiner more control over the content being discussed and may, in turn, increase intelligibility. Unfortunately, this improved intelligibility may sacrifice productivity and representativeness. In general, too much control restricts a child’s output. For example, sentence-building tasks in which a child is asked to “Make a sentence with the word X” elicit the least typical language and very short sentences (Wren, 1985). Words or structures divorced from dialogue, as in the previous example, require high-level metalinguistic skills and thus are difficult for a child with LI. Other tasks, such as sentence repetition, sentence completion, and judgment of grammaticality, are unreliable and should not be used without a spontaneous conversational sample (Fujiki & Willbrand, 1982). Yet, even though the more open-ended conversation may be more representative, it is usually less intelligible and may be difficult for some children with LI. For example, children with LD exhibit as much difficulty with conversations as with other assessment protocols (Donahue, 1984; Roth, 1986). Although specific stimulus items may increase intelligibility by controlling the topics discussed, increased intelligibility may result in decreased productivity as mentioned. Further, the child may

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develop or already have a stereotypic pattern of responding to the item. For example, a doll may elicit a “baby talk” style. The items chosen and the directions given also may affect the validity of the sample. For example, pictures can be used to elicit language, but the instructions given to a child often affect the quantity of language produced. The directive “Tell me about this picture” elicits less language than a more directive style (Wren, 1985), such as the following: I’d like you to make up a story from this picture. I want you to tell me a whole story that has a beginning and an end. Start with “Once upon a time” and tell me the whole story. The best advice for any SLP is to remain flexible in order to shift between different contexts and different content and to elicit the kinds of language behavior desired. An SLP should have a variety of stimulus materials and be skillful in discussing a range of topics potentially interesting to a child (Shriberg & Kwiatkowski, 1985). SU M MARY Descriptive approaches are not without problems. Although they are potentially more representative of a child’s everyday performance than formal testing, this potential is not guaranteed. In addition, descriptive approaches require that an SLP have considerable knowledge of language and of the variables that affect children’s language performance. Skillful manipulation of these variables by an SLP can enhance the potential intervention value of descriptive methods.

An Integrated Functional Assessment Strategy Speech-language professionals usually suggest a combined assessment approach (Kelly & Rice, 1986; Klein, 1984; McCauley & Swisher, 1984b). The purpose of the assessment should influence its design. Almost universally, SLPs would agree that no single measure or session is adequate (Emerick & Haynes, 1986). This allows for multiple assessment of language features and behaviors in a variety of relevant contexts. The SLP must consider the following seven variables in designing and implementing the assessment process (Kelly & Rice, 1986): 1. 2. 3. 4. 5. 6. 7.

Child’s chronological and functional age State of child’s sensory system (vision, hearing, etc.) Caregiver concerns Status of child’s psychological functioning Child’s interests and materials available Child’s activity level Child’s attention span

Judicious manipulation of some of these variables facilitates elicitation of a representative sample. In general, alternation of structured and less structured tasks keeps a child’s attention by providing variety. The SLP readily adapts the methods to each child and is mindful that children will respond differently to different adults.

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A combined or integrated assessment approach provides the most thorough individualized method of evaluation and includes a questionnaire and/or caregiver interview, an environmental observation, an SLP-directed formal psychometric assessment, and a child-directed informal assessment consisting of a conversational sample from the child. The actual components will differ with each child. Each component is discussed in the remainder of this chapter. At each diagnostic step, objectives should be derived from the information collected to this point. Thus, each step becomes more focused, and the possible language problems are highlighted. Figure 3.3 presents a possible stage process of collecting data. At each stage, the process becomes more focused. The following discussion deals with a number of assessment steps, both formal and informal, that are aspects of an overall integrated functional model. QU ESTION NAI R E, I NTE RVI EW, AN D R E FE R RAL Caregivers—parents, teachers, and others—are central to a functional assessment and intervention process (Kelly & Rice, 1986). Teachers can be a valuable referral source and should be encouraged to be alert for children with potential language problems. Parents can also be effective referral sources for children with more severe LI; however, they are less reliable in identifying mild impairment (ContiRamsden, Simkin, & Pickles, 2006). This is true even for children with SLI who, by definition, lack other obvious disabilities. Initial caregiver involvement helps build rapport, increases the validity of the assessment results, and introduces the caregivers to the intervention process. A caregiver interview or questionnaire can be a valuable source of initial information on client functioning and on the perceived problem from the caregiver’s perspective. Caregiver expectations for a child also provide an indication of a caregiver’s willingness and perceived need to work with the child. Caregivers should be encouraged to ask questions and to participate fully.

Questionnaire, Interview, and Referral

Observation

Formal Testing

Conversational Language Sampling

At each stage, data suggest a further delineation of the possible language impairment. In the next stage, the possible impairment can be more sharply defined. FIGURE 3.3 A model of the assessment process.

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With very young children, caregivers can be a source of information for difficult-to-test behaviors. For example, vocabulary checklists completed by parents correlate well with other measures of vocabulary (Bates, Bretherton, & Snyder, 1988; Beeghly, Jernberg, & Burrows, 1989; Dale, 1991; Dale, Bates, Reznick, & Morisset, 1989). In fact, parental reports on the size of their 2-year-olds’ vocabulary correlate well with the results of language screening tests (Klee, Carson, Gavin, Hall, Kent, & Reece, 1998). In other areas of oral language, such as intelligibility, parents are less accurate (Kwiatkowski & Shriberg, 1992). In face-to-face interviews it is best to ask questions of caregivers in a straightforward manner, with no hesitation that might signal embarrassment or discomfort. The SLP avoids tag questions (e.g.,“You don’t . . . , do you?”) that seek agreement, rather than confirmation or information. Responses are treated matter-of-factly with little comment that might discourage a caregiver from talking. The SLP will be interested in the child’s prenatal, perinatal, and postnatal medical history, family medical and educational history, the child’s educational and social history, and descriptions of the child’s behavior. A list of possible language questions is presented in Table 3.3. Caregiver responses are analyzed and hypotheses are formed before deciding on the strategy for the remainder of the assessment. Potential language problems are researched thoroughly. OB SE RVATION To gain the most natural interaction, an SLP will want to observe caregiver(s) and peer(s) with the child as conversational partners in such everyday settings as the home and the classroom. In the classroom, an SLP might observe the child participating in a number of activities. This situation is not always possible. Time may not permit observation alone. In this case, an SLP may wish to observe closely while collecting a language sample and may form tentative hypotheses for later confirmation from the analyzed sample. If observation occurs in a more clinical setting, appropriate toys and both structured and nonstructured activities are provided for the child and conversational partner. Caregivers are encouraged to use familiar objects and the child’s favorite toys or objects from home or the classroom. Ideally, the SLP would observe the child’s behavior with various communication partners. The SLP instructs caregivers to interact as typically as possible with the child. It is essential that caregivers not quiz or direct the child to perform during the observation. Optimum performance is attained if the SLP unobtrusively remains in the room or leaves and observes from outside via observation windows or video monitors. The style of interaction is more than just the frequency of various forms of behavior. More important are the ways in which a child uses the various features of his or her linguistic interactional style. The key question is, How does the child interact with others? Routinized situations may provide a child with a scaffold or frame within which language processing becomes automatized (Lieven, 1984). The SLP needs to assess the child’s familiarity with the situation and the degree to which that situation provides a prop for the child’s language. Atypical situations will not elicit typical performance. Although atypical situations may be useful vehicles for enhancing some children’s language performance, they can also suppress it and will not usually yield a representative sample of a child’s language. For most, but not all, children, play with familiar toys is a typical activity. The INREAL/Outreach Program of the University of Colorado recommends an observation strategy called SOUL. The acronym stands for silence, observation, understanding, and listening. The adult remains silent for periods of time, assessing the situation before talking. Observation of a child’s play

TABLE 3.3

Interview or Questionnaire Format

Questions relative to language uses: How does the child let you know items desired? What does the child request most frequently? What does the child do when requesting that you do something? When wanting you to pay attention? When wanting something? When wanting to direct your attention? Does the child ask for information? How does the child express emotion or tell about feelings? What emotions does the child express? Does the child make noises when playing alone? Does the child engage in monologues while playing? Does the child prefer to play alone or with others? Does the child describe things in the environment? How? Does the child discuss events in the past, future, or outside of the immediate context? Questions relative to conversational skill: When does the child communicate best? How does the child respond when you say something? How does the child respond to others? Does the child interact more readily with certain people and in certain situations, and if so, with whom and when? With whom and when does the child communicate most frequently? Does the child initiate conversations or activities with you and with others? What is the child’s most frequent topic? Does the child join in when others initiate conversations or activities? Does the child get your attention before saying something to you? How does the child do this? Does the child maintain eye contact while talking to you? Does the child take turns when talking? Does the child interrupt? Are there long gaps between your utterances and the child’s responses? Will the child take a turn without being instructed to do so or without being asked a question? When the child speaks to you, is there an expectation of a response? What does the child do if you do not respond? When the child responds to you, does the response usually match or is it relevant to what you said? How does the child ask for clarification? How frequently does this occur? If you ask the child for more information or for clarification, what happens? Does the child demonstrate frustration when not understood? When the child asks for or tells you something, is there usually enough information for you to understand? When the child tells you more complex information or relates an event or a story, is it organized enough for you to follow the train of thought? Does the child have different ways of talking to different people, such as adults and small children? Does the child phrase things in different ways with different listeners? Is the child more polite in some situations? Does the child seem confused at times? What does the child do if confused? Questions relative to form and content: Is the child able to understand simple directions? Does the child know the names of common events, objects, and people in the environment? What types of information does the child provide about these (actions, objects, people, descriptions, locations, causation, functions, etc.)? Does the child seem to rely on gestures, sounds, or the immediate environment to be understood? Does the child speak in single words, phrases, or sentences? How long is a typical utterance? Does the child leave out words? Are the child’s sentences complex or simple? How does the child ask questions? Does the child use pronouns and articles to distinguish old and new information? Does the child use words for time, such as tomorrow, yesterday, or last night? Does the child use verb tenses? Can the child put several sentences together to form complex descriptions and explanations? Source: Compiled from Brinton & Fujiki (1989); Lund & Duchan (1993); and Spinelli & Terrell (1984).

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and interactions with other people occurs prior to forming hypotheses. Understanding is the insight into a child that comes from the distillation of data collected during observation. Finally, listening requires total involvement by an adult and the use of responses appropriate to the functioning level of the child. The SLP obtains from the caregiver interview some notion of what to observe. Reliability of observation is increased if the SLP’s descriptions detail as closely as possible the actual observed behavior. Inferences and hypotheses come later. It is best if the observation is taped or digitally recorded for later referral. Handheld computers also have been shown to be an effective and reliable way to collect language data in situations where it is used, such as in the classroom (Olswang, Svennson, Coggins, Beilinson, & Donaldson 2006). Table 3.4 is a list of some features that an SLP might observe. This list is not exhaustive. Each category is discussed in some detail in Chapters 6 and 7, where we consider the analysis of a conversational sample. The purpose of observation is to note within the larger scope of interaction the language characteristics to be tested, collected, and analyzed later in the assessment. Reliability of observation is not fortuitous. SLPs should train together thoroughly so that their observations are as accurate and as objective as possible. This accuracy and objectivity can be accomplished by repeated observation and rating of recorded samples by more than one SLP. Ratings then can be compared, discussed, and modified in light of reexamination of the samples. FOR MAL TESTI NG Within an evaluation session or sessions, a change to more formal testing tasks might be accomplished through the use of a nonthreatening receptive task, possibly one requiring only a pointing response. Such a task allows a child to become accustomed to an SLP’s direction. An annotated list of several current tests is presented in Table 3.5.

TABLE 3.4

Features to Note While Observing the Child

Form of language. Does the child use single words, phrases, or sentences primarily? Are the sentences of the subject-verb-object form exclusively? Are there mature negatives, interrogatives, and passive sentences? Does the child elaborate the noun or verb phrase? Is there evidence of embedding and conjoining? Understanding of semantic intent. Does the child respond appropriately to the various question forms (what, where, who, when, why, how)? Does the child confuse words from different semantic classes? Language use. Does the child display a range of illocutionary functions, such as asking for information, help, and objects; replying; making statements; providing information? Does the child take conversational turns? Does the child introduce topics and maintain them through several turns? Does the child signal the status of the communication and make repairs? Rate of speaking. Is the rate inordinately slow or fast? Are there noticeable or lengthy pauses between the caregiver and child’s turn? Are there noticeable or lengthy pauses between the child’s adjacent utterances? Does the child use fillers frequently or pause before producing certain words? Are there frequent word substitutions? Sequencing. Does the child relate events in a sequential fashion based on the order of occurrence? Can the child discuss the recent past or recount stories?

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TABLE 3.5

Communication Assessment

Helpful Hints for Language Testing

Test

Description

Comments

Carrow Elicited Language Inventory (Carrow, 1974)

Consists of 52 sentences that the child repeats Contains scoring/analysis form and verb protocol Ages 3 to 7-11

One of only a few tests that are normed for 3-year-olds. It scores the number or errors rather than the number of correct responses. The norms are tricky, because older children tend to modify the sentences to make them conform more closely to speech, e.g., substituting “doesn’t” for “does not.” Test should be audio-recorded for accuracy in scoring, but you can gain a quick idea of a child’s performance by marking each sentence as the child repeats it. The total errors can be quickly counted for an approximate error score. While easy to administer and a bear to score, the analysis yields vital information on language form.

Comprehensive Receptive and Expressive Vocabulary Test, 2nd edition (Wallace & Hammill, 2002)

Test of receptive and expressive vocabulary via pointing to pictures named and providing definitions Ages 4 to 89-11

Expressive vocabulary definitions are sometimes unusual when testing children with LI. Be prepared to have to interpret whether a response is correct or incorrect, even though the developers have tried mightily to anticipate responses. My favorite wrong answer for cider was “Her lunch was inside her.

Fullerton Language Test for Adolescents, 2nd edition (Thorum, 1986)

Overall language test with Very difficult adolescent test. subtests in syntax, morphology, I question the value of the semantics, and syllabication Syllabication subtest for students Ages 11 to adult. of this age. The Morphology Competency subtest is extremely difficult to score because the examiner must decide on the correctness of the response with very little guidance.

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TABLE ) TABLE 3.5 3.5 ( continued Helpful Hints for Language Testing Test

Description

Comments

Peabody Picture Vocabulary Test, 4th edition (PPVT) (Dunn & Dunn, 2007)

Child or adult points to one of four pictures named Ages 2–6 to 89–11

Be careful not to overextrapolate from the results. The test, despite its claims, merely measures a client’s ability to match a picture with a name. It tells us nothing about depth of understanding or definitions. Nouns are overrepresented despite that this type of word becomes a smaller portion of our lexicons as we mature.

Test of Adolescent and Adult Language, 4th edition (Hammill, Brown, Larsen, & Wiederholt, 2007)

Overall language test with subtests in written and spoken language in syntax and semantics Individual or group administration Ages 12 to 24-11

Good general test; easier than the Fullerton. Sentence Combination subtest will be very difficult for clients with auditory working memory problems. Spoken Analogies subtest is related more to cognitive abilities than language abilities.

Test of Auditory Comprehension of Language, 3rd edition (TACL-3) (Carrow-Woolfolk, 1999)

Consists of three subtests: Vocabulary, Grammatical Morphemes, and Elaborated Phrases and Sentences Ages 3 to 9-11

Often a child will pass the first two subtests but fail the third. This occurs with children who have language form difficulties and/or auditory memory problems. Norms are available by subtest, so to shorten the test, you might wish to give only this subtest. Extremely distractible children may need to be reminded to look at all the pictures. Although this violates test norms, remember that the test was not normed on children who are other than typical. Report your findings, and note that this score was only attainable with reminders to stay on task. (After all, are we measuring language or distractibility?)

(continues)

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TABLE ) TABLE 3.5 3.5 ( continued Helpful Hints for Language Testing Test

Description

Comments

Test of Language Development–Intermediate, 4th edition (Hammill & Newcomer, 2007)

General language test with several subtests covering semantics, morphology, and syntax Ages 8 to 17-11

Good overall test. Some of the two-word descriptors used in the picture vocabulary subtest are unnecessarily difficult. The Word Ordering subtest will be especially difficult for children with poor auditory working memory. While the task is fun to do, I question its relevance to the real world. When was the last time someone approached you and said, “Party fun was the”? The Malapropisms subtest is fun to give as long as you don’t fall over the errors and give them away, but again I’m not positive of its relevancy.

Test of Narrative Language (Gillam & Pearson, 2004)

Assesses narrative skill in three modes: no pictures, single pictures and sequential pictures Assesses both literal and inferential comprehension Ages 5 to 11-11

Good overall measure of an area that may be difficult to assess through sampling and is difficult to analyze. Systematic data collection method.

Word Test Elementary, 2nd edition & Word Test Adolescent, 2nd edition (Bowers, Huisingh, LoGiudice, & Orman, 2004)

Comprehensive test of word associations, synonyms, semantic absurdities, antonyms, definitions, and flexible word use Ages 6 to 11-11 & 12+

Thorough evaluation of the mental mapping networks in which words are stored. The adolescent test is greatly improved over the previous edition. The developers have done a nice job of anticipating responses to the definition subtests. You’ll still receive some weird ones.

Assessing All Aspects of Language It is important that the SLP make a thorough assessment of all aspects of language. Only rarely is a language impairment limited to one aspect alone. Should this be the case, however, as with a highfunctioning child with TBI who manifests only lingering pragmatic difficulties, testing of all aspects confirms the absence of problems and provides a holistic image of the child’s language. This task may necessitate more than one session with the child and caregivers. Even when problems in a single area, such as vocabulary, are suspected, more than a single test should be used in order to best describe the

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language deficit (Grey, Plante, Vance, & Henrichsen, 1999). Issues relative to each aspect of language are discussed in the following section. Pragmatics. Very few tests are available that assess a child’s conversational skills. In general, the tests are of two varieties—storytelling and topic discussion. In both test situations, the essential feature of conversational relevance is strained, and it is doubtful that a true description of a child’s abilities is attained. For example, the topic discussion format makes it difficult to assess question comprehension (Moeller, Osberger, & Eccarius, 1986). As a result, questioning is sampled inadequately, restricted in type, and lacking in variation of communicative contexts (Parnell & Amerman, 1983). The nature of pragmatics makes formal testing difficult. It is also difficult to establish reliable norms, because such aspects of pragmatics as the amount of talking, the frequency of initiations, the type of discourse structure, and the register are situationally related. At present, it seems more appropriate to use a conversational sample to assess children’s language use. Semantics. Although children with LI have a range of semantic difficulties with acquisition, storage, and retrieval, most formal assessments are limited to receptive and expressive vocabulary. Few standardized tests assess multiple aspects of semantic knowledge. At the very least, we should be interested in word knowledge, novel word learning, word categories, figurative language, multiple meanings, and word-finding. When does an SLP know that a child has learned a word? Tests typically assume an all-ornothing phenomenon in which a child either does or does not know the meaning (Crais, 1990). In reality, acquisition of word knowledge is a gradual process that may continue through the lifetime of an individual. An individual child’s success or failure on a test item may be dependent on several factors, such as the type of task or the manner of cuing. Testing tasks are often contrived, out of context, and highly literate (Nippold, Scott, Norris, & Johnson, 1993). Testing of semantic abilities often is confined to picture identification, word definitions, and word categories. Of interest are a child’s comprehension and production vocabularies. Comprehension vocabulary usually is measured by having a child point to a picture that best represents the word produced by the test administrator. Such tests tell an SLP very little about the frequency of use or the depth or breadth of a child’s understanding of the concept named. Comprehension of longer utterances usually is assessed by having a child follow simple commands or directives. When a word is not fully understood by a child, he or she may rely on other comprehension strategies based on linguistic features, such as word order, or on nonlinguistic features, such as the position or size of stimulus items, such as pictures (Edmonston & Thane, 1992). During testing, an SLP should note behaviors such as locational preferences in pointing responses and verbal comments that accompany responding. Expressive or productive vocabulary usually is tested by having a child name pictures or supply a definition. Scoring may be of a correct-incorrect or scaled type. The latter allows for partially correct responses. Descriptions by the SLP of the type of definition given by a child can be valuable in determining the maturity of the child’s lexicon. Early definitions usually rely on use. These are followed in order by descriptions, use in context, synonyms and explanations, and finally, conventional definitions (Curtis, 1987). The entire process takes years to accomplish. The Diagnostic Evaluation of Language Variance (Seymore, Roeper, & deVilliers, 2003), a criterionreferenced tool, includes a subtest of novel word learning. SLPs also may wish to develop their own evaluative instruments (Brackenbury & Pye, 2005). For example, incidental learning can be examined using

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either unknown words or nonsense words within contexts in which the referent or entity referred to is present but not directly defined. Follow-up testing can determine if the word was learned. A number of factors, such as word length, syllable structure, and familiarity of consonant clusters, influence phonological working memory, where words are held while processed. For this reason, it seems unwise for an SLP to design informal measures of phonological form storage unless she or he has researched this area thoroughly (Brackenbury & Pye, 2005). Typically, phonological storage and processing are assessed through nonword repetition tasks such as those found in the Children’s Test of Nonword Repetition (Gathercole & Baddeley, 1996). Several assessment instruments have subtests of semantic categories and connectors between words. Sorting and labeling tasks can be used in informal assessment. Categorical understanding is assessed by asking the child to supply an antonym or a synonym or to name related words in a category. Between ages 5 and 9, children undergo a change in the organization of language, from a syntactic to a more categorical system. Thus, category membership and related words, not just simple word meaning, should be tested with all children in late elementary and high school. Word-association tasks such as naming another member of a category may be ineffectual in differentiating children with LI and those without (Kail & Leonard, 1986). Responses are dependent more on the familiarity of the category and the number of responses possible (Crais, 1990). Other semantic-related tasks include giving antonyms or synonyms, stating similarities and differences, telling all one knows about a word, detecting semantic absurdities, explaining figurative language, and noting multiple meanings. Each task requires different abilities, including determining the task demands, focusing on critical semantic dimensions, and interpreting cues, that can be complicated by word-retrieval difficulties. Children with LD or TBI exhibit word-finding and word-substitution difficulties. Little is known about word-retrieval processes. In children, the words substituted usually share some visual attributes with the target word referent, such as saying sheet for cape and net for screen. Late elementary school children with LD exhibit more visually related word-substitution errors than do TD children (German, 1982). Additional word-finding substitutions found in children with LD include functional descriptions, such as book holder for shelf. Diagnostically, use of these word-finding strategies indicates that a child comprehends the word but has difficulty retrieving it. Although testing may reveal a deficit in naming skills, such tests rarely indicate the nature of the deficit. Identification of the word-retrieval strategies of these children may aid in the design of remediation techniques directly related to these strategies. Word-finding difficulties can be assessed formally with measures such as the Test of Word Finding, Second Edition (TOWF-2) (German, 2000), and informally using a format similar to that used by the TOWF-2. It is important to distinguish between those words unknown to the child and those known but difficult to retrieve. Usually, the referents of unknown words cannot be identified by a child through pointing when their names are presented. In contrast, if a child can identify referents receptively but not name them on a different occasion, word-retrieval problems may be present. In informal assessment, especially in severe cases, such as the initial stage of recovery from TBI, it may be useful to begin with common everyday objects and actions in the environment. One method for attaining more information from tests is a double-naming technique (FriedOken, 1987). In this procedure, a standard naming test is administered twice. The results are examined to identify error response groups that occur once and twice. The errors that occur on both administrations require further analysis.

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The SLP can administer a number of cues with the double-error words to determine whether the errors indicate word-finding difficulties and to identify naming strategies. In this procedure, cues are administrated in the following order (Fried-Oken, 1987): 1. General question. The child is asked a general, open-ended question, such as, “Can you think of another word for this?” or “What is this again?” that provides no additional linguistic information. 2. Semantic/phonemic facilitator. Two cues, based on additional semantic and phonemic information, are administered. The order of presentation varies, but the SLP should record carefully the order and the response. The semantic cue describes the object’s function, provides a categorical label or states the location. For example, if the picture shows a sofa, the SLP might say,“It’s something you sit on,”“It’s a piece of furniture,” or “You find it in the living room.” The child’s response and the type of semantic prompt should be noted. The phonemic cue includes the initial phoneme of the desired label (“The word starts with a /_/.”) This type of cue requires certain metalinguistic skills of a child in order to use the information given. 3. Verification. If a child is still incorrect, the SLP provides the correct label and asks whether the child has ever seen this object before in order to verify whether the word is in the child’s repertoire. The child’s responses and the cues are analyzed to determine the qualitative nature of the errors and the child’s naming strategy. Possible naming strategies of 4- to 9-year-old children are listed in Table 3.6.

TABLE 3.6

Naming Strategy Categories

Naming Strategy

Example

Phonological Perceptual Semantic Semantic + perceptual

foon/SPOON lampshade/SKIRT tortoise/OCTOPUS broom/MOP shirt/JACKET shoelace/SHOE you can play songs/PIANO it has numbers and hands/CLOCK in a band/TAMBOURINE food/CRACKERS Shetland pony/HORSE canoe/HARMONICA canoe/MUSHROOM I don’t know/GLOVE 10+ seconds of silence/MITTEN “strumming”/GUITAR

Part/whole Functional circumlocution Descriptive circumlocution Contextual circumlocution Superordinate Subordinate Unrelated perseveration Comment No answer Gesture

Source: Reprinted with permission from Qualitative examination of children’s naming skills through test adaptations by M. Fried-Oken. Language, Speech, and Hearing Services in Schools, 18, 206–216. Copyright © 1987 by American Speech-Language-Hearing Association. All rights reserved.

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Syntax Syntactic testing can be extremely complicated because of the complexity and diversity of the syntactic system. SLPs may wish to use entire test batteries or portions of several tests. The latter strategy is recommended for in-depth probing of potential problem areas. Naturally, when tests are used in a nonstandard manner or are combined with other subtests, the norms can no longer be used. Results must be described accurately and interpreted in light of the tasks involved. There is considerable variability across tests in the length of individual syntactic items, the structures tested, and the type of testing tasks used. Test tasks are as diverse as highly unnatural ones, such as word ordering or unscrambling and sentence assembling, and more natural tasks such as sentence combining (Nippold et al., 1993). Many mirror the highly decontextualized tasks found in school, such as fill-in-the-blank, but do not reflect everyday language use. In general, development of comprehension of syntactic forms typically precedes production. Thus, a thorough language assessment should include evaluation of both aspects. Although the receptive procedures used and the structures assessed vary widely across tests, the common element is that a child demonstrates understanding—usually by pointing to a picture or following directions—while producing only minimal language, if any. Syntactic production typically is tested by using either a structured elicitation or a sentence imitation format. In structured elicitation, a child might be asked to describe a picture, following a model by the test administrator. The model sentence establishes the sentence form to be used (she is running) but differs from the desired sentence by the structure being tested (she will run). In sentence imitation, a child gives an immediate repetition of the test administrator’s sentence. The underlying assumption of elicited imitation procedures is that sentences that exceed a child’s working memory will be reproduced according to a child’s own linguistic rule system, which the child must use as a processing aid. Theoretically, the child’s sentence should be very similar to the one the child would produce spontaneously. Thus, the child’s imitated sentence should not contain any structures absent in the child’s spontaneous language production. Although elicited imitation serves as the basis of a number of diagnostic instruments and as a portion of several other tools, the validity of the procedure has been questioned frequently. Although the performance of children with LI on elicited imitation tests can be enhanced by the addition of contextual cues, such as pictures or object manipulation, their imitations are still simpler than their spontaneous language production. Assumptions about the performance of TD children may not apply to children with LI. Because the relationship between elicited imitation and spontaneously produced language is a very complex one, SLPs are advised to use elicited imitation results with caution and to rely on the data from spontaneous samples when the two differ (Fujiki & Brinton, 1987). Elicited imitation responses should be analyzed for the specific ways they differ from the model. Table 3.7 on pages 96–97 provides a method of scoring sentence imitation tasks that maximizes the available information for clinical use (Mattes, 1982). Each response is scored for grammatical acceptability, type of syntactic error, semantic equivalence, and quality of response. Such analysis is much richer than simple correct/incorrect scoring. Morphology Morphological testing usually focuses on bound inflectional morphemes. Most tests emphasize suffixes, such as tense markers, plurals, possessives, and comparators, because of their high usage and relatively early development. In general, children with good spoken and written language abilities have more morphological awareness and do better on such tests (R. C. Anderson & Davison, 1988; Bailet, 1990; Fisher, Shankweiler, & Liberman, 1985; Liberman, Rubin, Duques, & Carlisle, 1985; Nagy, Anderson, Schommer, Scott, & Stallman, 1989; Snow, 1990).

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Suffixes can be divided into two types: inflectional and derivational. Inflectional suffixes indicate possession, gender, and number in nouns; tense, voice, person and number, and mood in verbs; and comparison in adjectives and do not change the part of speech of the base. For example, a noun can be made plural with the addition of the -s marker, but the noun remains a noun. The second, larger category, derivational suffixes, is ignored in most tests. Derivational suffixes have a smaller range of application and many more constraints and irregularities than inflectional suffixes. Application may be unpredictable, as with -tion, which can be added to some but not all nouns. Also, the meaning can be somewhat unclear, as with -ment in apartment. More than 80 percent of multimorpheme words do not mean what the constituent parts suggest (White, Power, & White, 1989). The development of derivational suffixes is not as clearly understood as that of inflectional suffixes but seems related to oral language production abilities, reading level and exposure, derivational complexity, and metalinguistic awareness (Carlisle, 1988; Fisher et al., 1985; Nagy, Anderson, & Herman, 1987; Nagy, Herman, & Anderson, 1985; Tyler & Nagy, 1987; Wysocki & Jenkins, 1987). The two most common expressive test formats for morphology are cloze, or sentence completion, and sentence imitation. Most cloze procedure test items give the root word and require the child to respond with the root plus a suffix, as in teach and teacher. Tests use either actual words or nonsense words. The rationale for nonsense words is that their use will not bias performance by previous exposure. In general, tests using nonsense words are more difficult for young children (Channell & Ford, 1991). Children with either MR or LLD have greater difficulty with nonsense word tests than children developing typically. Other testing tasks might include judgments of relatedness of words, such as hospital and hospitable, ability to deduce meaning from component parts, and ability to form words in different and changing linguistic contexts (Moats & Smith, 1992). Although several tests have morphological portions or subtests, most have too few items and too narrow a scope to provide much valuable information (Moats & Smith, 1992). Prefixes and derivational suffixes are included on only a few tests. Written Language A written sample should also be collected, especially if dyslexia or LD is suspected. It should include first drafts of expository writing, narrative fiction, and nonfiction. The SLP can evaluate the sample for phonological and linguistic awareness; word boundaries; vocabulary and usage; ability to communicate thoughts precisely, sequentially, and systematically; generation and organization of ideas; morpheme usage; syntactic usage, semantic awareness, and word associations, such as opposites and synonyms; and handwriting (Greene, 1996). This area of assessment will be discussed in detail in Chapter 13. Test Modification As mentioned previously, tests can be modified to provide the information desired by an SLP. For example, an SLP may wish to test a child’s pronoun use in depth. No test is available that adequately assesses only these structures. An SLP might construct his or her own assessment tool from portions of other tests. I’ve listed several tests, with modifications and comments on use, in Table 3.8. This type of locally prepared test may be very useful for thorough assessment. Obviously, individual test standards of administration have been violated and the norms would be invalid. Occasionally, published tests include subtest norms. In this case, a subtest on pronouns may be administered in its entirety as directed in the instructions, and the norming information would be applicable. Test administration may be modified also for the child who cannot perform as required or for further investigation of the child’s response strategies. For example, use of pictures or repetition of

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Elicited Language Analysis Procedures Format

Student’s Name: Birthdate: _______________ Examiner: ______________________________ Test Date: _________________

Instructions: Record the child’s responses in the spaces below. Score responses in terms of grammatical acceptability, syntactic usage, vocabulary usage, and response quality by placing a check mark in the boxes that most accurately describe the response.

Vocabulary

Response Quality Comments

Grammatical Acceptability Correct: Identical Correct: Nonidentical Substitution Error Deletion Error Insertion Error Modification Error Word Sequence Error Non-Attempt Error Equivalent in Meaning Related in Meaning Unrelated in Meaning Delayed Response Self-Corrected Response Perseverative Response

Test Item #

Syntactic Usage on Structure Tested

The child’s elicited imitation is written in the appropriate column at the left. Omissions, substitutions, changes in meaning and the like are noted by marking the appropriate column. The errors and target structures can be recorded under the Comments column, such as “Omit past-tense -ed” or “Change passive voice to active.” Such analysis may help delineate unlearned structures and the cognitive-linguistic knowledge base. Response Categories Grammatical acceptability. Child’s response is a complete and grammatically correct sentence. Syntactic usage on structure tested. The manner in which the grammatical structure tested is produced. A. Correct production: identical sentence frame. Child’s response is an identical word-for-word reproduction of the model. B. Correct production; nonidentical sentence frame. The grammatical structure being tested is produced correctly, although the sentence frame differs from the model. C. Substitution error. The child substitutes an inappropriate grammatical form for the structure being tested. D. Deletion error. The child inappropriately omits the grammatical structure being tested. E. Insertion error. The child inserts the grammatical structure being tested within a sentence frame where it is inappropriate. F. Modification error. The child produces a modification of the grammatical structure being tested that is not acceptable in any context (e.g., him’s, ain’t, it’s is). G. Word sequence error. The child produces the grammatical structure being tested in an appropriate position within the response. H. Non-attempt error. Performance cannot be evaluated (e.g., I don’t know).

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Vocabulary usage. Manner in which the child’s response relates semantically to the stimulus sentence. A. Equivalent in meaning. Although the specific vocabulary used by the child is not identical to the model, the response is identical in meaning. B. Related in meaning. The child produces a response that is partially related to the meaning of the model. The child may omit essential elements or modify vocabulary. C. Unrelated in meaning. The child produces a nonmeaningful response or one that is unrelated to the model. Response quality A. Delayed correct response. The child produces a correct response that is nonimmediate, requires a repetition of the model, or is produced after hesitation during response. B. Self-corrected response. The child self-corrects an incorrect response without prompting by the examiner. C. Perseverative response. The child produces a response that resembles that used on a previous test item but that is inappropriate for this item. Source: Reprinted with permission from The elicited language analysis procedure: A method for scoring sentence imitation tasks by L. Mattes. Language, Speech, and Hearing Services in Schools, 13, 37–41. Copyright © 1982 by American Speech-Language-Hearing Association. All rights reserved.

instructions may enhance the performance of some children. It is important to remember that nearly all tests are designed for TD children. The child with MR or cerebral palsy is at a very distinct disadvantage. In such cases, description of a child’s ability when procedures are modified may be much more useful for intervention than a score. Adherence to prescribed test procedures is more likely to result in a measure of that child’s limitations. Testing procedures may be modified through the use of multiple sessions, increased time to respond, and increased trials. For children with attentional difficulties, an SLP might enlarge materials, use a penlight or pointer, highlight certain information, verbally remind the child to attend, or have the child repeat the test cue prior to responding. The performance of children with motor problems, ASD, or LD might be affected also by visual or auditory distractions, placement of materials, temperature, lighting, light and dark contrasts, and positioning. Children who perseverate may need to be reminded that the correct answer for one item is not the same for another. Children with memory problems may need to have cues repeated, to repeat cues aloud themselves, or to have cues broken into easily processible units. Finally, children with TBI may need a longer time to respond. The SLP also should test beyond base and ceiling scores to identify “islands” of learning. Other modifications for children with TBI may include reduction of distractions, different response modes, enlarged print and reduction of print per page, simplified instructions, substituting multiple choice questions to facilitate recall, giving multiple examples, providing breaks when fatigue is evident, and darkening lines or print in visual displays (Russell, 1993). SAM PLI NG Conversational sampling has the potential for providing the most accurate description of the child’s language as it is actually used in conversational exchange. Although sampling usually includes freeplay and unstructured conversation, it also may include structured conversation and probing of language

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features noted in observation and testing. In the next several chapters, we discuss the best ways to maximize the information from this source through design of collection situations and analysis methods.

Assessment for Information-Processing Deficits As mentioned in Chapter 2, children with a variety of disorders exhibit difficulty processing verbal information. Although questions about cognitive functioning should be answered by a team that includes at least a neurologist, a psychologist, and an SLP, probing by the SLP can answer some questions and suggest alternative methods of intervention. Standardized testing will provide some insight but is no substitute for comprehension and production of language in real-life contexts. Of most importance are changes in performance under varying task demands. The SLP can assess a child’s performance by varying the speed of information using both familiar and unfamiliar words and structures (Ellis Weismer & Evans, 2002). Usually there is a tradeoff between accuracy and timing. The SLP can assess memory with a variety of inputs, both verbal and nonverbal (Montgomery, 2002a). These may include digit and word tasks and nonword repetition. The length of the units to be repeated can be varied in both number and unit size, such as number of syllables and their complexity. In the classroom, the SLP can observe and assess note taking and expository writing (see Chapter 13). The SLP can read sentences to the child and have the child combine them or answer questions about the content. Longer units can be read and the child asked to identify content in the beginning, middle, and end. Finally, the SLP should use the test-teach-retest form of dynamic assessment, the most ecologically sound manner for assessing cognitive functioning (Gillam et al., 2002). Discussed in more detail in Chapter 4, dynamic assessment is concerned with the child’s ability to learn rather than his or her level of past learning. For example, in the teaching phase, the child may be taught to identify the main idea in a paragraph or to interpret a comment, conversation, or narrative. In the retest phase, the SLP focuses on the kinds of change and the effort required. Of interest throughout are the child’s ability to attend, perceive, and recall information, understand explanations, relate past information to new, infer, and generalize.

Conclusion There is no one way to assess children with LI. A combination of interviewing, observation, testing, and sampling/probing offers a holistic approach that can incorporate not only the child but also significant others and familiar communication contexts. It’s important as you move through an assessment not to become too absorbed in the minutia of various isolated language features. This “forest for the trees” (N. W. Nelson, 1998) syndrome can result in missing the holistic nature of the child’s communication system. Once all the data is assembled, final analysis begins. More data may be needed. If collection can be characterized as somewhat scientific in its approach, analysis, while similar in nature, requires more of the artist in each SLP, as he or she paints an individual portrait of each child with LI. More of this in Chapters 5 through 8.

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anguage differences, such as dialects or the influence of a first language on a second, are not disorders. Such differences are valid rule-governed linguistic systems in and of themselves. A child learning a nonstandard dialect of American English or learning American English as a second language may also exhibit language disorders, such as LD, SLI, or any of the others discussed in Chapter 2. The task for the SLP is to separate these natural differences from disorders. An increasing proportion of children in U.S. schools are culturally and linguistically diverse. Results of the 2000 U.S. census indicate that 18 percent of the population age 5 and greater, approximately 47 million people, speak a language other than English at home. Of these, approximately 21 million indicated that they didn’t speak English well (Shin & Bruno, 2003). These numbers includes many Latino Americans and Asian Americans and some Native Americans for whom English is a second language. In addition, a portion of working-class African Americans use African American English, a dialect of American English. Nationally, approximately 11 million children speak English as a second language. In New York state, more than 130 languages are represented in the schools (Heberle, 1992). In many large cities, more than 50 percent of the school population is children from culturally linguistically diverse (CLD) backgrounds. In general, these children have a greater dropout rate, are less successful in school, are overrepresented in special education classes, and are underrepresented in programs for the gifted. The primary reason for children with limited English being referred for possible special education placement is difficulty with English (Damico, 1991b). Unfortunately, in the United States, children with CLD backgrounds often live in poverty. This status can be related to a higher incidence of teen pregnancy, poor prenatal care, drug and alcohol abuse, low birth weight, poor nutrition, childhood illness and injury, and communication disorders. In addition, the demographics of immigration have changed recently to include many more immigrants from economically poor countries with poorer educations and few of the high literacy skills demanded by the changing U.S. economy (Heberle, 1992). The differences are both linguistic and cultural. Within the CLD population is a continuum of proficiency in English (ASHA Position Paper, 1985), including bilingual English proficiency, limited English proficiency (LEP), and limited proficiency in both English and the first language. It is important that an SLP be able to distinguish between a disorder and a difference that is the result of interaction of the native language and English. SLPs must appreciate the rule-governed nature of native languages and know their contrastive features. Elective speech and language services may be provided to individuals who are bilingual English proficient and who desire more standard production of English. It is important for an SLP to remember, however, that dialects of English that reflect the influence of the native language on English are not disorders. Individuals who are limited English proficient (LEP) are proficient in their native language but not in English. Assessment and intervention should be conducted in the native language as mandated by federal law (PL 94-142 and PL 95-561), legal decisions (Diana v. Board of Education, 1970; Lau v. Nichols, 1974; and Larry P. v. Riles, 1972), and state educational regulations. Adequate service delivery by an SLP requires native or near-native fluency in both languages and ability to describe speech and language acquisition in both languages, to administer and interpret formal and informal assessment procedures, to apply intervention strategies in minority language, and to recognize cultural factors that affect service delivery to the CLD community (ASHA Position Paper, 1985). For the remainder of the text, we shall use the term LEP to refer to children learning English as their second language. Other children will be specified as needed. Finally, those with limited proficiency in both English and the native language are truly communicatively handicapped. Language testing should establish language dominance and the most appropriate language for intervention (ASHA Position Paper, 1985). One error often made by inexperienced

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SLPs is to assume that the native language (L1) is dominant. Young children may lose L1 as they begin to acquire a second language (L2), which in this case is American English.

State of Service Delivery Although the demographics of the United States are changing, the overwhelming majority of SLPs will continue to belong to the majority culture for the foreseeable future (Shewan, 1988). Approximately one in three SLPs has some bilingual clients, but more than 80 percent of these professionals do not feel confident in their abilities to serve these clients (Shewan & Malm, 1989; Taylor, 1989). It’s estimated that only 2 percent of certified members of ASHA are able to provide services in languages other than English (Langdon & Cheng, 2002). Inadequacies include a lack of academic preparation and experience, unfamiliarity with the language and/or culture, and a lack of appropriate assessment tools (Adler, 1991).

LACK OF PR E PARATION AN D EXPE R I E NCE Most academic programs offer little preparation for working with children with CLD backgrounds through either coursework or practicum. Until this deficiency changes, it is the responsibility of each SLP to educate him- or herself through continuing education. The following are some ways to interact more with culturally diverse populations: Work alongside a bilingual speech-language pathologist as an assistant. Take a foreign language course and/or a course in cultural diversity. Join cultural organizations and attend cultural festivals. Become a Big Brother or Big Sister or volunteer to work with culturally diverse youth. Volunteer in organizations such as Habitat for Humanity. Join organizations, such as National Coalition Builders Institute, that foster cooperation and understanding. Join church groups that foster interactions with inner-city churches. Go out of your way to introduce yourself to individuals from other cultures. Each SLP should remember that when he or she enters the environment of another cultural group, he or she is a guest and should act accordingly. Members of the majority culture sometimes expect members of minority cultures to accept them with open arms. My experience has been that there is a period of adjustment in which mutual trust is built. Only then does acceptance begin to grow.

U N FAM I LIAR ITY WITH LANG UAG E AN D CU LTU R E Becoming familiar with another culture and another language requires shedding many preconceived notions and becoming culturally aware. This requirement is followed by education about particular languages and cultures and about language development among CLD children. It is extremely difficult

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to become fluent in a second language as an adult or from classroom instruction. Therefore, one method for an SLP to use to overcome linguistic deficits is language interpreters. This alternative is discussed at the end of this section. Growth of Awareness All aspects of our lives are overlaid by culture. It affects our institutions and the way we act and think. Culture is a shared framework of meanings within which a population shapes its way of life. Culture is what one needs to know or believe to function in a manner acceptable to a particular group (Campbell & Champion, 1996). It is neither static nor absolute, but has been shaped by the population’s history and evolves as individuals constantly rework it and add new ideas and behaviors. It includes, but is not limited to, history and the explanation of natural phenomenon; societal roles; rules for interactions, decorum, and discipline; family structure; education; religious beliefs; standards of health, illness, hygiene, appearance, and dress; diet; perceptions of time and space; definitions of work and play; artistic and musical values, life expectations, and aspirations; and communication and language use. Culture interacts with language to influence cognitive and affective processes and the interpretation of behavior (Westby, 1995). Each culture has a unique outlook. It is essential for SLPs to recognize that culture is pervasive and diffused throughout their own lives. Culture forms the basis for their values and worldviews. Therefore, culture influences the way individuals view other cultures. SLPs from the majority culture in the United States typically have Euro-centered standards. These standards will influence each SLP’s decisions about LI, although these standards may not apply to individuals from other cultures. For example, Vietnamese culture is much more tolerant of speech and language diversity than is U.S. majority culture. Likewise, the Navajo culture values a quiet, introspective persona, which may seem withdrawn by U.S. majority standards. Language differences affect much more than language form, including rules for appropriate interaction in specific contexts, awareness of content information required in different situations, appropriate structures for participation, and communication styles (Westby, 1995) Words and concepts also are related culturally. For example, the word and the concept crib are not found in Korean. Table 4.1 offers other examples of cultural variants. Although SLPs cannot know all cultures, they can become increasingly culture sensitive. It is important to respect other cultures and to recognize that no one culture is the standard (N. Anderson, 1991). Cultural sensitivity requires not only recognition of one’s own culture but also examination of cultural notions held as “truths.” Many traditional notions of the U.S. majority culture, especially those involving poverty and ethnicity or race, are inappropriate in our global environment. The following are guidelines for interacting with clients from different cultures (Taylor, Payne, & Anderson, 1987): 1. Each encounter is a socially situated communicative event subject to cultural rules governing such events by both participants. 2. Children perform differently under differing conditions because of their unique cultural and linguistic backgrounds. 3. Different modes, channels, and functions of communication may evidence differing levels of linguistic and communicative performance.

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Cultural Variants That May Influence Assessment

Concept

Other Cultures*

Majority U.S. Culture

Achievement

Cooperation and group spirit. Accept status quo. Manual labor respected.

Emphasis on competition and success. Define self by accomplishments. To the victor go the spoils.

Age

Elders are revered. Growing old is desirable.

Youth is valued.

Communication

Respectful, avoid eye contact, loudness for anger. Silence means boredom. Nonlinguistic and paralinguistic important.

Casual, direct eye contact, loud voice acceptable. Silence means attentiveness. Emphasize verbal.

Control

Fate.

Free will.

Education

Formal for few. Entrance into mainstream society. Elders, peers, and siblings are teachers. Active, physical learning. Spontaneous, intuitive. Testing not integral.

Universal, formal, verbal. Key to social mobility. Teacher is authority. Classroom passivity rewarded. Reflective, analytical. Tests are part of learning.

Family

Extended, kinship important, more varied, elder or parent centered. Male or female dominated.

Nuclear, small, contractual partnership, child centered.

Gender/role

Males independent, pampered. Females have many home responsibilities.

Relative equality.

Individuality

Humility, anonymity, deference to group.

Individual makes own life. Stress self-reliance.

Materialism

Excessive accumulation is bad, status ascribed.

Acquisition, symbol of success and power.

Social interaction

Contact, physical closeness. Kinship more important than friends.

Noncontact, large interpartner distance. Large group of friends desired.

Time

Enjoy the present, can’t change future. Little concept of wasting time. Flexible.

Governed by clock and calendar, punctual, value speed, future oriented. Time is money. Scheduled.

*No specific culture. Source: Complied from Chamberlain & Medinos-Landurand (1991); Goldman & McDermott (1987).

4. Ethnographic techniques and cultural norms should be used for evaluating behavior and making determinations of LI. 5. Possible sources of conflict in assumptions and norms should be identified prior to an interaction and action taken to prevent them from occurring. 6. Learning about culture is ongoing and should result in constant reevaluation and revision of ideas and in greater sensitivity. This new awareness should lead to a recognition that “assessment is a subjective process that is highly influenced by the socio-political, cultural, and linguistic context” (Chamberlain & Medinos-

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Landurand, 1991, p. 112). In fact, to make sense of our behaviors, we must view them against the background of culture. Education in Language, Culture, and Language Development Sensitivity by SLPs is not enough. You must educate yourself about the dialects, languages, and cultures of the individuals you serve and about the process of dialect and second-language learning. Typically, SLPs make two common errors in evaluating the language of children with CLD backgrounds. Either children are identified incorrectly as having a language disorder, or those with a disorder are missed. For example, African American children from rural Alabama who speak the African American English dialect common to that area continue to delete final consonants beyond the age at which middle-class European American children do (Haynes & Moran, 1989). An SLP who is unaware of this difference might conclude, incorrectly, that these children exhibit a disorder. Cultures The breadth of cultural diversity is beyond the scope of this text. Suffice it to say that each SLP should become familiar with the cultures that he or she serves. Reading and observation are both essential methods of learning. An SLP must remember that cultures are not monolithic and that there is much heterogeneity, especially in the Latino American population. The need for professionals to understand and appreciate the beliefs and values of families from CLD backgrounds is critical. One study found that both parents and Head Start staff were unaware of their differing assumptions about education, parenting, child learning, and disability (Hwa-Froelich & Westby, 2003). Of particular importance are differences in child-rearing practices, family structure, attitudes toward LI and intervention, and communication style. Variants of communication style include nonlinguistic and paralinguistic characteristics, such as eye contact, facial expression, gestures and intenation; intercommunicant space and the use of silence and laughter; pragmatic aspects, such as roles, politeness and forms of address, interruption rules, turn taking, greeting and salutations, the ordering of conversational events, and appropriate topics; and the use of humor (Fasold, 1990; SavilleTroike, 1986; Taylor, 1986b). It is best if an SLP is somewhat cautious at first, until he or she has a sense of cultural expectations. Cultures differ in their beliefs about health, disability, and causation. A great deal of discomfort may surround disorder and intervention. Some families will be surprised by the extent of their expected role in intervention. Dialects and Second-Language Learning It is not possible to learn all of the dialects or languages one might encounter, especially in large metropolitan areas. Therefore, each SLP should attempt to learn the contrastive influences between other languages and dialects of children being served and Standard American English. Common phonological, syntactic, and morphological contrasts are found in Appendix A. SLPs can also learn high-usage words and forms of greeting in the language served. Not all children with different dialects are the same. Each child’s language will differ with the specific dialect spoken and the maturity of language and dialect development. Although data are limited, we know that children learning African American English, the dialect spoken by some inner-city and Southern rural African Americans, show only minimal evidences of their dialect by age 3. Earlier development is closer to the middle-class standard. By age 5, however, most African American English forms are being used, at least in part.

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It is important for an SLP to remember that the range and frequency of dialectal forms will vary across children (Washington & Craig, 1994). Awareness and discrimination of dialects appear to increase slowly throughout elementary school while actual production gradually shifts to more standard use (Isaacs, 1996). Interestingly, speaking a minority dialect does not influence the ability to comprehend the majority dialect. Children in the United States who are bilingual Spanish-English or who use Spanish only may perform very differently even from each other (K. Wilcox & McGuinn-Aasby, 1988). These differences may reflect U.S. regional differences, country of origin, or dialectal or socioeconomic differences (M. Norris, Juarez, & Perkins, 1989). In general, second-language learning is more difficult than first-language learning, which for most children is fairly effortless. A language assessment must distinguish between those errors that reflect this difficulty and those that represent a language impairment. Most children are sequential bilingual learners: The first language (L1) has reached a certain level of maturity before acquisition of the second language (L2) begins. Sequential learning may maximize the interference between the two languages. Interference is the influence of one language on the learning of another. For example, the English /p/ is difficult for Arabic speakers but not for Spanish speakers because of L1. Interference in simultaneous bilingual acquisition seems to be minimal (Genesee, 1988). Children who learn L1 at home and are not exposed to L2 (English) until school move toward L2 dominance in middle school, but the transition occurs earlier in comprehension than in production, suggesting interference in production (Kohnert & Bates, 2002). The monolingual model of development is inappropriate when describing second-language learning (Roseberry & Connell, 1991). Likewise, rate of learning is a poor index because of the many variables that affect second-language learning. Preschool children will have an immature L1 when introduced to L2. The result may be “semilingualism,” in which a child fails to reach proficiency in either language. A child may be delayed in development of L1 after exposure to L2 if the second language, is dominant in the culture. This situation is rarely considered in language assessments (Langdon, 1989). In general, competence in L2 is related to the maturity of L1. The more mature a child’s use of L1, the easier it is to learn L2 (Jacobson, 1985). Initially, a child in preschool may be silent for a while on exposure to L2 and appear to have a language impairment. It takes time for a child to decipher the linguistic code (Schiff-Myers, Coury, & Perez, 1989). Older children possess metalinguistic skills that aid in this deciphering process. School-age children exposed to L2 may appear to have LD. The decontextualized language of the classroom may be especially difficult. If exposure to L2 does not occur until after age 6, it may take five to seven years to acquire age-appropriate cognitive and academic skills. The result is that in the United States many children have never fully developed L1—often Spanish—and are deficient in academic use of English (L2). L1 may exhibit arrested development or be lost if it is not used, is not valued by the child, is discouraged by the parents, or is considered less prestigious. Factors that affect L2 competency are individual characteristics, such as intelligence; learning style; positive attitude about one’s self, one’s own native language, and the target language; extrovertism and a feeling of control; a lack of anxiety about L2 learning; and home and community characteristics, such as parental and community attitudes and the level of literacy in the home. Low socioeconomic status alone is not a negative factor but may be paired with poor literacy or poor L1 use in the home and/or little opportunity to converse one-on-one with mature L2 users (K. Nelson, 1985). When compared to adults learning L2, children show a greater readiness to learn, are more perceptive of sounds, are less subject to interference from L1, and learn through sensory activity within

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the immediate context (Hamayan & Damico, 1991). Adult learning is verbal and abstract, emphasizing rule learning; children form their own abstractions of the rules from context. Children tend to acquire “chunks” of language, usually high-usage phrases, with conscious rule learning becoming more important after age 9 (Hamayan & Damico, 1991). Although children usually do not learn L2 faster or more easily than adults, they eventually outperform them (Genesee, 1987). Children are more likely to take language learning and use risks. In general, L1 forms a foundation for the learning of L2. What a child knows from one language is transferred to the other. This may be general knowledge about sentence construction and parts of speech or similar language processes if the languages are similar. Of course, interference also can occur, but its effects are usually minimal (Madrid & Garcia, 1985; Wolfram, 1985). A poor base in L1 usually leads to difficulties in L2. Languages other than English are devalued in the United States. This is the result of racial and ethnic discrimination and has resulted in a bilingual educational policy that sends a very clear message on the relative value of English (Schiff-Myers, 1992). The result is weakened linguistic and ethnic ties. The most common educational paradigm is a transitional bilingual program in which a child receives two or three years of bilingual education prior to placement in a monolingual English classroom. The not-so-subtle message is that English is better. Long-term maintenance programs that attempt to continue use and development of L1 are rare (Schiff-Myers, 1992). A period of even three years is insufficient for the child to attain academic proficiency in English. It is important that an SLP recognize the process of sequential bilingual acquisition. This is a dynamic process; a child’s language is changing. Performance may vary widely within and across children. Therefore, language assessments need to be tailored individually to each child (Hamayan & Damico, 1991; Hyltenstam, 1985). LACK OF APPROPR IATE ASSESSM E NT TOOLS We can expect the performance of CLD children on formal tests to be affected by cultural differences. Negative listener or tester attitudes also affect children, causing poor performance. The result is lower expectations and inappropriate referral or classification (Cummins, 1986). Few nonbiased standardized language tests are available for evaluating children with CLD backgrounds (Bernstein, 1989). Tests are typically unique to one culture or language. Spanish versions of most tests fail to consider dialectal differences and are normed on monolingual children (GutiérrezClellen & Simon-Cereijido, 2007). In two judicial decisions regarding placement of Mexican American and African American children in classes for the retarded (Diana v. State Board of Education, 1991; Larry P. v. Riles, 1984), the courts ruled that judgments made on the basis of responses to tests whose norming populations are inappropriate for these children are discriminatory. Many of the tests widely used in speech-language pathology are normed on population samples with a disproportionately high number of middle-class, European American, English-only children. Tests may yield lower scores for lower socioeconomic groups and for African American children. Some test items may be culturally biased against certain children. A critical need exists for nonbiased language testing for children of color, especially those from lower socioeconomic backgrounds (Rhyner, Kelly, Brantley, & Krueger, 1999). Having said all this, when we survey SLPs, we find that most use formal, standardized English tests to assess bilingual children (Caesar & Kohler, 2007). In general, poor performance leads to lower expectations (Adler, 1990). It is inappropriate to compare children with LEP to native speakers of English. The use of chronological norms is especially

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questionable, given the great variety in developmental rate among CLD populations (Seymour, 1992). The child with LEP does not have language similar to a native speaker of English of a certain age. The problem becomes deciding what standard to use (Lahey, 1992).

Overcoming Bias in an Assessment The goal of a communication assessment with children with LEP is to differentiate difficulties that result from experiential and cultural factors from those that are related to language impairment (Damico, 1991b). Both groups may have some language difficulties. Adolescents in need of intervention also exhibit greater difficulty expressing themselves, establishing greetings and opening and maintaining a conversation, listening to a speaker, and cueing a listener to a topic change (Brice & Montgomery, 1996). Both cultural and linguistic factors influence performance in an assessment (Chamberlain & Medinos-Landurand, 1991). These may lead to misinterpretations and miscommunication. An SLP must be careful not to stereotype behavior and draw incorrect and unfair conclusions. For example, Latino American children may seem uncooperative and inattentive, when, in fact, their behavior signifies different concepts of time, body language, and achievement. An SLP can avoid biasing data interpretation by asking the following questions (Damico, 1991b): 1. Are there other variables, such as limited exposure to English, infrequency of error, testing procedural mistakes, extreme test anxiety, or contextual factors, that might explain the difficulties exhibited with English? 2. Are similar problems exhibited in L1? 3. Are the problems exhibited related to second-language acquisition or dialectal differences? 4. Can the problems exhibited be explained by cross-cultural interference or related cultural phenomena? 5. Can the problems exhibited be explained by any bias effect related to personnel, materials, or procedures that occurred before, during, or after assessment? 6. Is there any systematicity or consistency to the linguistic problems exhibited that might suggest an underlying rule? An SLP should interpret the child’s performance in light of the intrinsic and extrinsic biases inherent in the assessment process. Intrinsic biases, such as knowledge needed and normative samples, are part of the test, while extrinsic biases, such as sociocultural values and attitude toward testing, reside in the child. When groups of minority children score similarly to the norming population—as on the Communication and Symbolic Behavior Scales (Wetherby & Prizant, 1993)—it suggests a less biased assessment device (Roberts, Medley, Swartzfager, & Neebe, 1997). Similarly, the Expressive Vocabulary Test (Williams, 1997) is a screening measure that has been reported to be culturally fair and appropriate for use with African American children (Thomas-Tate, Washington, Craig, & Packard, 2006). On the other hand, scores of low-income African American children on the Preschool Language Scale–3 (Zimmerman, Steiner & Pond, 1992) suggest that, even though the test is generally nonbiased, some items should be interpreted with caution because they are problematic for these children (Qi, Kaiser, Milan, Yzquierdo, & Hancock, 2003). Language use patterns of both a child and an SLP and the language-learning history of that child also may influence the assessment. Communication and interactive style are culture bound.

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Bias can be overcome by addressing cultural and linguistic influences in a four-step process (Chamberlain & Medinos-Landurand, 1991): 1. Recognize and identify variables that might affect the assessment. 2. Analyze tests and procedures for content and style. For example, the Fluharty Speech and Language Screening Test accepts an /f/ for /θ/ substitution on teeth as dialectal, but in New Orleans, African Americans substitute /t/ to produce teet (/tit/) (Campbell & Champion, 1996). In addition, simply asking children to repeat what the SLP says may go against the cultural norm. Some African American children are not expected to imitate adults. 3. Take variables into account and change procedures. 4. Teach test-taking strategies. An SLP should be mindful that each child’s level of acculturation will differ with the age of the child and the extent of exposure to both cultures. USE OF I NTE R PR ETE R S The accuracy of testing with children with LEP may be increased by using interpreters who speak the child’s primary language (Watson, Omark, Gronell, & Heller, 1986). When an interpreter is not available, family members can aid the SLP. Children with CLD backgrounds perform significantly better with familiar examiners (Fuchs & Fuchs, 1989). This finding suggests the use of interpreters familiar with both the language and the culture of a child and his or her caregivers. In addition, it suggests that consistency is important. An SLP must recognize the limitations of the process and must select and train the interpreter carefully. They must work together as a team with mutual respect. Three factors seem critical in the use of interpreters: selection, training, and relationship to the family and community (N. Anderson, 1992; Chamberlain & Medinos-Landurand, 1991; Randall-David, 1989). Let’s say a little more about each one. Selection Selection should be based on a potential interpreter’s linguistic competencies, ethical and professional competencies, and general knowledge and personality (Chamberlain & Medinos-Landurand, 1991). An interpreter should possess a high degree of proficiency in both L1 and English, be able to paraphrase well, be flexible, and have a working knowledge of developmental, educational, and communication terminology. Ethical and professional competencies should include an ability to maintain confidentiality, a respect for the feelings and beliefs of others and for the roles of professionals, and an ability to maintain impartiality. Confidentiality is especially important if the interpreter is a resident of the immediate geographic area served. Finally, it is very desirable for the potential interpreter to have a knowledge of child development and educational procedures. Personal attributes include flexibility, trustworthiness, patience, an eye for detail, and a good memory. Training Training must include the critical factors of assessment and intervention, including procedures and instruments (N. Anderson, 1992). The interpreter must understand the importance of exact translation from L1 to L2 and the reverse.

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Preassessment training must include the elements of a thorough assessment and the methods of specific test protocols, including technical language. Rapport-building strategies and questioning techniques also should be taught. Prior to each evaluation of a child’s language, the SLP and the interpreter should review each case and the assessment procedures; practice pronunciation of the name, introductions, questioning, and nonlinguistic aspects of the interaction; and discuss the topics to be introduced. During the evaluation, the interpreter can interact with the child and caregiver(s) while the SLP records the data and directs the process. In the postassessment interview with caregivers, the interpreter will convey the results of the evaluation as they are reported by the SLP. Relationship with Family and Community Prior to the assessment, the interpreter should try to get to know the caregiver(s) and child. It is very important that the interpreter convey the confidentiality of the proceedings, especially if the interpreter is from the community. During the assessment, the interpreter is to translate exactly. The SLP can aid this process by keeping interactional language simple and use of professional jargon to a minimum. It is the interpreter’s responsibility to ensure that the caregivers thoroughly understand the process and the results and recommendations. Conclusion Working through interpreters is difficult and does not address some of the other problems in assessment with children with LEP. The following list contains suggestions for working successfully with an interpreter (Lynch & Hanson, 1992; Randall-David, 1989). The SLP should 1. Meet regularly and keep communication open and the goals understood. 2. Have the interpreter meet with the child and caregiver(s) prior to an interview to establish rapport and to determine their educational level, attitudes, and feelings. 3. Learn proper protocols and forms of address in the native language. 4. Introduce himself or herself to the family, describe roles, and explain the purpose and process of the assessment. 5. Speak more slowly and in short units, but not more loudly. 6. Avoid colloquialisms, abstractions, idiomatic expressions, metaphors, slang, and professional jargon. 7. Look directly at the child and caregiver(s), not at the interpreter. Address remarks to the caregiver(s). 8. Listen to the child and caregivers to glean nonlinguistic and paralinguistic information. What is not said may be as important as what is said. 9. Avoid body language or gestures that may be misunderstood. 10. Use a positive tone that conveys respect and interest. 11. Avoid oversimplification and condescension. 12. Give simple clear instructions and periodically check the family’s and child’s understanding. 13. Instruct the interpreter to translate the client’s words without paraphrasing. 14. Instruct the interpreter to avoid inserting her or his own word or ideas in the translation or omitting information. 15. Be patient with the longer process inherent in translation.

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Although these suggestions will not ensure success, they may lessen some friction that potentially could disrupt effective delivery of services. ALTE R NATIVE ASSESSM E NT The following five guidelines should be considered prior to using standardized tests with children from CLD backgrounds (Musselwhite, 1983): 1. What is the relationship of the norming population and the client? Are enough minority children included to give a fair representation? Are separate norms used for different minority groups? 2. What is the relationship of the child’s experience and the content areas of the test? Items using farm content, for example, may have little relevance for children in the inner city. 3. What is the relationship of the language and/or dialect being tested and the child’s language and/or dialect dominance? This issue is critical in determining language impairment. The determining factor should be the child’s ability to function within her or his own linguistic or dialectal community (Iglesias, 1986). 4. Will the language of the test penalize a nonstandard child by use of idiomatic or metaphoric language? 5. Is the child penalized for a particular pattern of learning or style of problem solving? Test scores should not be taken at face value. For example, the omission of some morphological endings by bilingual children is similar to the error pattern of children with SLI, leading to possible misdiagnosis (Paradis, 2005). Although differences do exist, they are often subtle and require great care when examining assessment results. When bilingual Spanish-English children who are typically developing (TD) and those with LI are compared on use of English past tense, different error patterns emerge (Jacobson & Schwartz, 2005). In addition to scoring lower with regular past-tense -ed on real and nonsense verbs and with irregular past tense verbs, bilingual children with LI made significantly more omission errors, while TD children made overgeneralization errors (eated, sitted). All is not lost. American English standardized tests can be used with modified procedures to enhance performance. Modifications may aid an SLP in describing a child’s language and communication skills. Obviously, the scores from such testing would be invalid, although the descriptive information may be invaluable. If reported, the scores must be qualified by a description of the modified procedures. Dual sets of norms—those from the test and locally prepared ones—can be used to compare the performance of children from CLD backgrounds to that of the standard group and of their peer group (Musselwhite, 1983), but they must be used cautiously because most likely the test will still be in Standard American English (Seymour, 1992). It seems more appropriate to measure a child’s performance in his or her dialect and compare this performance to that of other children also using that dialect (Seymour, 1992). Unfortunately, we have very little data on this development and even fewer tests. Parents, who presumably speak the same dialect, may be used as referents when very little normative data are available (Terrell, Arensberg, & Rosa, 1992). A language test can be given to both the parent and the child. Once enough data has been gathered, the SLP can compare the child’s performance with that of the adult. Assuming the adult has no language impairment, child use that reflects parent use but that differs from Standard American English would represent a dialectal difference, not a disorder. For example, omission of final plosives found in African American English would result in omis-

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sion of the regular past tense marker -ed. Just testing the child, an SLP might assume that the child does not have past tense. Parental omission would confirm a dialectal difference. Some tests have been normed on population samples from different languages, such as children speaking English and Spanish, by using English and a Spanish translation. Results of translated tests must be used very cautiously because they assess structures important for speakers of English and ignore those of the other language. For example, hitting something with a stick in English is sticking in some Spanish dialects, but that verb is not used with other types of hitting. The standardized norms from such translated tests could be used to identify children with language differences. Children who exhibit LI relative to their peer group could be identified by use of the peer group norms. Even this procedure may bias some results, given the diversity of some populations, such as Latinos. Norms for all speakers of a language fail to consider dialectal variations. Other variables, such as socioeconomic status, family grouping, length of time exposed to English, and quality of L1 used at home, affect the child’s performance. Locally prepared norms may be more appropriate. The differences found between majority and minority children on knowledge-based tests are not found on process-based evaluations (Campbell, Dollaghan, Needleman, & Janosky, 1997). It may be possible to reduce bias in language testing of children with CLD backgrounds by using methods and tools that emphasize processing abilities, such as memory and perception, rather language experience and knowledge (Campbell, et al., 1997). Process-based tests can be useful in distinguishing LI from experiential difference. Processes are the mental operations required to manipulate linguistic material. Testing might include such tasks as nonword vocal repetition, completion of two language tasks simultaneously, and following directions. To ensure that past learning is minimized, tasks should be completely novel, and task-related vocabulary and grammar should be familiar or, if not, reviewed prior to testing.

An Integrated Model for Assessment Current methodology in language assessment has been described as a “discrete point approach” (Acevedo, 1986; Mattes & Omark, 1984) in which language is treated as an autonomous cognitive ability divided into many components (Damico, 1991b). Language is not viewed as holistic; rather, it is separate from environmental variables and context. We addressed this issue in the previous chapter. It is not surprising that several SLPs have suggested an integrated approach for CLD children, one that uses the child’s natural environment and that depends on descriptive analysis, rather than on normative test scores. Language and communication are not static, divisible, and autonomous, but dynamic, synergistic, and integrative (Damico, 1991b). Such an assessment would focus on the functional aspects of language and on flexibility of use. The overall question would be: “Is this child an effective communicator in his or her context?” The criterion is not norm referenced, but “communication referenced” (Bloom & Lahey, 1978), with an SLP determining the indices of proficiency. Data could be collected in natural settings (Iglesias, 1986) as a child converses with his or her natural conversational partners, parents, teachers, and peers. Assessment would begin with data gathering. This collection process might include screening all children for other-than-English and for nonstandard dialectal use. This step could be followed by referral information from classroom teachers on children experiencing academic difficulty (Chamberlain & Medinos-Landurand, 1991). Early intervention may prevent difficulties or inappropriate classification later (Garcia & Ortiz, 1988). A teacher checklist of the child’s language functions, a questionnaire,

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and/or caregiver interview might follow. Parents can also be a source of information. Not surprisingly, Spanish-speaking parents are as accurate in reporting the expressive vocabulary and grammar of their toddlers as monolingual English-speaking parents (Thal, Jackson-Maldonado, & Acosta, 2000). Parental reports of bilingual children’s vocabulary and word combinations are consistent with sampling findings (Patterson, 2000). In addition to verifying demographic information, an SLP should observe the child in the classroom and with peers and caregivers. Of interest is the child’s language use, academic strengths and weaknesses, and learning style. Data collection and observation would be followed by testing and language sampling. Sampling should include a wide variety of settings and activities to increase the accuracy of the language sample collected (Bernstein, 1989). Parents can be trained to listen to their child, observe language use, and discuss linguistic interactions. CH I LDR E N WITH LE P The data collection stage is particularly important for children with LEP. Many variables affect secondlanguage development and are of interest. In addition, seemingly simple information such as age—Is the child age 1 at birth or a year later?—is culturally dependent and can greatly affect determinations of impairment. Considerations for children with LEP include the degree of exposure to English-speaking peers, self-esteem, personality (introverted vs. extraverted), motivation to learn English, family attitude toward English, ethnic community’s view of education, the socioeconomic status of the family and of Englishspeaking peers, and the process of learning a second language (Roseberry-McKibben, 1994). The same child may appear very different depending on the stage of second-language development. Four measures may be especially important in discriminating predominantly Spanish-speaking children with LI from those developing typically (Restrepo, 1998). These are parental reporting, a family history of speech and language problems, the number of errors per T-unit, and the mean length of T-units. A T-unit is a main clause and phrasal or clausal embedding attached to it. T-units will be discussed in more detail in Chapter 7. Language assessments should occur where a child and her or his caregivers are most comfortable, such as the home. Parents, especially recent immigrants, may speak little or no English. A properly trained interpreter can be very helpful in obtaining needed information. Occasionally, older siblings have sufficient English skills to answer questions or to translate for their parents. Table 4.2 contains possible questions to be asked in an interview. TABLE 4.2

Interview Questions for Children with LEP or Children with Different Dialects

Demographic How long has the family been in the United States? In which country were the parents born? From which country did the family immigrate? How much contact does the family have with their native country? * How long has the family been in this community? Is the family connected to a large community from their native country? Is there any plan to return to the native land to live?

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Family * How old is the child? * Which family members live in the household? Number of siblings? * Are other individuals living in the household? In what cultural activities does the family participate? * Who is primarily responsible for the child? (Primary caregiver?) * Who else participates in caregiving? * Approximately how much time do the child and caregiver spend together on a typical day? * With whom does the child play at home? * How much education do family members have? In what language? Childrearing * Are there scheduled meals? * What types of foods usually are eaten? * Is there an established bedtime? * Does the child misbehave? How? How is the child disciplined? Who disciplines? Are any television shows (radio shows, videos) in the native language? If so, how often does the child watch such shows? * Are stories read or told to the child? If so, in what language? How often? * Are there books, magazines, or newspapers in the home? In what language? * At what age did the child begin school? * Has the child attended school regularly? * How many schools has the child attended? What language has been used in the classroom? Attitudes and Perceptions * Is blame assigned for the child’s problems or condition? To whom or what? * How does the family view intervention? Is there a feeling of helplessness? How does the family view Western medical practices and practitioners? Who is the primary provider of medical assistance and information? * From whom does the family seek assistance (organizations and individuals)? * What are the general feelings of the family when seeking assistance? * Does one family member act as the family spokesperson when seeking assistance? * How is the child expected to act toward parents, teachers, or other adults? Adults toward the child? Are there any restrictions or prohibitions, such as the child not making eye contact or not asking questions? * How important are English language skills? Language and Communication What language is spoken in the home? Between adults? Between caregivers and the child? Between the children? When playing with neighborhood friends? Other caregivers and the child? How much English is used in the home? What language is used in community activities, such as church, Girl Scouts, and team sports? At what age did the child begin to learn English? Where and how? * At what age did the child say the first word? Use two-word utterances? *Applicable to both LEP and dialectally different children. Source: Compiled from N. Anderson (1991); Chamberlain & Medinos-Landurand (1991); Mattes & Omark (1984); SchiffMyers (1992); Wayman, Lynch, & Hanson (1990).

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Observation should occur in several settings with different conversational partners, topics, and activities. This tactic will give an SLP some idea of the extent of bilingualism and possible language and communication difficulties. Because the manner of a child’s development of two languages and the child’s environment interact, it is important to assess in both languages. Each child’s language skills must be compared to sociolinguistic factors such as the following: at exposure to each language • Age Extent to each language • Ability ofto exposure use each language • Comparative linguistic structure of the two languages • Individual child differences (Goldstein, 2006) • Assessment in both languages is especially important for preschool and kindergarten children in order to evaluate development in both (Hammer, Lawrence, & Miccio, 2007). The languages used in testing and the manner of their presentation differ with each child and the purpose of the evaluation. It is important to establish the primary language, language dominance, and language proficiency in both languages. Testing in both L1 and English seems essential for assessment of language impairment. In fact, federal law requires bilingual testing before such determinations are made. Successive testing in the stronger language, followed by the weaker, results in the best performance, especially for young children with monolingual L1 homes (Krashen & Biber, 1988), although simultaneous testing may be best for children who exhibit poor competence in both languages or who speak a combined L1 – L2 language, such as “Spanglish” (Cummins, 1986). The mode of administration and scoring can greatly change the reported responses of bilingual children on vocabulary assessment. The number of correct responses increases as SLPs move from monolingual to bilingual administration and from monolingual scoring to conceptual scoring in which the child is credited for different aspects of meaning (Bedore, Peña, Garcia, & Cortez 2005). If, for example, a Spanish-English-speaking child is shown a picture of housecat, she might respond with “cat” or “gato” or with both words. That is one aspect of the definition, the entity’s name. If the child adds, “It’s like leon in jungle,” she has added a new aspect to the definition and demonstrated conceptual knowledge. This example is very simplistic. Conceptual knowledge can be assessed using questions such as the following in response to objects and pictures. Tell me three things about . . . Describe what an X looks like. This is Rosa. Tell me what she looks like. What shape is X? What do you do with X? What is the difference between X and Y? What are they going to do? Normative testing should be supplemented by probing. As mentioned, children with CLD backgrounds score lower on knowledge-based testing, such as that found in normative procedures, but the same on process-based assessments, such as comprehension and production of real conversations (Campbell et al., 1997). Dynamic assessment tasks are more appropriate and deemphasize grammar in favor of

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ability to communicate and learn (Butler, 1993; Damico, 1991b). Tasks are interactive, focused on learning, and yield information on learner responsiveness (Gillam, Peña, & Miller, 1999). Dynamic assessment is based on the educational notion of zone of proximal development (Vygotsky, 1978), or the difference between a child’s current performance on a task and the amount of guided assistance needed by the child to be successful. Thus, in dynamic assessment an SLP is interested not only in a child’s performance but also in the best way to facilitate learning and in the child’s ability to respond to learning. The three primary methods are “testing the limits,” graduated prompting, and testteach-retest (Gutierrez-Clellan, & Peña, 2001). In testing the limits (Carlson & Wiedl, 1992), an SLP probes behind a child’s response using elaborative feedback and verbal explanations by a child to determine his or her understanding of the task and the way in which he or she arrived at the response. For example, a child may have interpreted the word buoyancy as boy-in-seat (Peña, 2002). Graduated prompting is a method of probing a child’s readiness for learning. By subtly manipulating the prompts given to a child, the SLP determines the level of support needed by a child in order to be successful. In essence, the SLP is trying to bridge the gap between what a child knows and the requirements of the task. In a test-teach-retest format, an SLP becomes an active agent of change. Focusing on “how” rather than “what” children learn, language-neutral dynamic tasks can provide a nonbiased assessment (Lidz & Peña, 1996). The initial test establishes a baseline measure, then during teaching the SLP supports learning and discovers how modifiable a child is and how a child responds to adult support. The method of teaching called mediated learning experience (MLE) is an individualized approach to the response and strategies used by a child and includes explaining the importance of the learning and giving evaluative feedback (Peña, 2002). Several types of mediation are possible (Lidz, 1991), including mediation of the following: Informing a child of the purpose for the interaction and attempting to maintain • Intentionality: a child’s involvement Focusing a child’s attention on important features and helping a child understand their • Meaning: importance and relevance Bridging concepts and learning beyond the immediate context by relating • Transcendence: specifics of the task to other experiences Encouraging a strategic, deliberate approach to problem solving and manipulat• Competence: ing a task to help a child be successful The focus is not simply on what a child learns but also on how a child learns. An example of MLE is presented in Table 4.3. In retesting, or posttesting, children with LI usually demonstrate little change (Pena, Iglesias, & Lidz, 2001). The SLP is also interested in the way in which a child thinks that results in the answers the child gives. This requires probing of a child’s responses. One method of testing or probing that circumvents an SLP’s inability to speak the native language and the affects of delayed English acquisition is the invented rule (Connell, 1987c; Roseberry & Connell, 1991). For example, an invented rule might state that /i/ is added to a noun to mean a portion of that noun, as in book and book-/i/. This procedure can be taught through modeling and can be tested with novel objects. Modeling would be a two-step process: “This is X, X,” as the speech-language pathologist points. “This is X-/i/, X-/i/,” as the speech-language pathologist points.

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TABLE 4.3

Communication Assessment

Examples of Mediated Language Experiences (MLE)

Introduction Today we’re going to play with some special toys and use them in special ways. While we’re using the toys we’ll think about the actions we do with each and the different names we use. Now, what are we going to be talking about? [Child response] Um-hm, and why do you think it would be important to be able to name the different actions that we can do? [Child response] Good, so we can explain our actions to other people. Can you think of anything else? [No response] Do you ever ask for some help from your mother? [Child response] And . . . [Child response] Yes, of course, we can use actions to ask others to help us. Suppose I called your mother and said, “Dad!” [Child response] You’re right, it would be the wrong name. To help people understand us, we call things by their right name. I know that you have a dog. What’s his name? [Child response] Okay, if I called him something else, would he answer? [Child response] No. So names are important. We call actions by their right name too. I have a whole box full of different objects. Some tell us what we do with them. Here’s one your mother uses. It’s called an iron. And what do we do with it? [Child response] Right, we iron, we iron clothes. That was a hard one. How should we name the actions that go with each object? [No response] Would it help to name the object? [Child response] Okay, let’s begin that way. Suppose that you know the name of the object but not the name of the action? [Child response] Well, I could tell you but can you think of a way to show me what you know? [Child response] Good, you could show me by doing the action. Then together we can figure out the name of the action, maybe from the object used or their might be other ways to remember. . . . [Lesson continues]

Within lesson Now we’ve named all the actions. Some objects have more than one. Let’s try something else. You name the action and I’ll name the object. Only one rule, you cannot repeat an action. If you can’t think of the action, act it out and I’ll try to help. . . . [Continues] Do you know how to play Simon Says? [No response] Well, in this game you get to be the queen and you tell me what to do. Let’s use your name: “Catalina says, ‘Eat!”’ [SLP pretends to eat in a very sloppy manner. Child laughs.] Now you try one. . . . [Continues] Wow, that was fun. What a busy queen you are! Look at this. I have a book full of actions. Let’s see if we can describe what’s happening in the book. . . . [Continues]

Conclusion You worked really hard today. Do you remember what we learned? [Child response] Why are action names important? [Child response] And what did you do when you couldn’t think of the action word? [Child response]

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This would be repeated several times with a few items as the child repeats the SLP’s production of the noun and the noun plus /i/. Testing would follow a cloze procedure: “This is Y, Y. This is _____.” Again the SLP would point to pictures illustrating the meaning. Of interest is whether a child can abstract a language rule and then apply it to novel situations, certainly an important skill for language learning. Naturally, the same picture of objects would not be used for both testing and training to enable the SLP to assess learning and generalization. Possible pictures to be used for testing or training are presented in Figure 4.1. For example, the SLP says, “This is clock; this is _____ (clocky).”

11 12 1

11 12 1

10 9

2

8

4

3 7

6

5

10 9

2 3

8

4 7

6

5

FIGURE 4.1 Possible format for invented rule assessment.

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Structured tasks designed by an insightful SLP can also provide more flexibility than standardized tests and may be effective assessment vehicles (R. T. Anderson, 1996). Table 4.4 is an example of a structured format that has been used effectively with Spanish-speaking 4-year-olds. Throughout this text, I stress the need for alternatives to standardized testing, such as language sampling. For children from CLD backgrounds, language sampling and ethnographic interviewing are essential parts of any language evaluation (Battle, 2002). Although useful, language samples are not guaranteed to be nonbiased. All interactions are culturally based and have the potential of biasing results against a child. Members of the community or family should aid the SLP in analyzing a child’s language sample. Sampling should reflect an “authentic assessment” (Udvari & Thousand, 1995) based on the realistic demands of a child’s communication contexts, such as the classroom. In this setting, a sample should reflect the contextual, performance, and instructional constraints of the situation (Rosin & Gill, 1997). A child can then be measured against the minimal competency needed to function within that context (Stockman, 1996). Authentic assessment is a clear example of the functional assessment methods described in this text. Of course, children’s responses will differ with the task used to elicit language. For example, based on the type of narrative eliciting task, bilingual Spanish-English 4- to 7-year-old children’s narratives will differ in both the amount of each language produced and the amount of language mixing (Fiestas & Peña, 2004). CH I LDR E N WITH DI FFE R E NT DIALECTS Naturally, an SLP will want to gather similar data about a child with a minority dialect. Possible interview questions are contained in Table 4.2. Observation and testing are similarly important. TABLE 4.4

Script for Structures Task

A. Negatives Materials

Prompt

1. broken doll 2. car with wheels missing 3. small box/large object 4. empty box 5. box that will not open

1. Ask child to show body part that is missing. (¿Dónde está _____?) 2. ¿Qué le pasa al carro? 3. Pon (object) en la caja. 4. Busca _____ en la caja. 5. Abre la caja, por favor.

B. Verbs: third-person singular and plural—past and present progressive Materials: family, house, and furniture Perform the following actions with one family member (singular) and with more than one family member (plural). 1. 2. 3. 4. 5.

dormir comer cocinar saltar/brincar bailar(se)/lavar(se)

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Verbal prompts: Ahora vamos a (action). 1. past tense—Yo (action—past tense). ¿ Qué hizo/hicieron? 2. present progressive—A mí me gusta (action) y a éi/ella/ellos también. ¿ Qué está pasando? C. Verbs: third-person present indicative Materials: doll house and dolls Prompts: While playing with the dolls, talk about different things that people do, such as “Las mamás cocinan; los niños corren.” Then ask: 1. 2. 3. 4. 5.

¿ Qué hacen las mamás? ¿ Qué hacen los niños? ¿ Qué hacen las maestras? ¿ Qué hacen los pájaros? ¿ Qué hacen los perros?

D. Copula “ser” Prompt: Provide incorrect information when identifying objects. Use the furniture and the dolls for prompting. For example, say that the mother doll is the father doll and insist on it. Repeat this with the following: 1. 2. 3. 4. 5.

mother/father table/chair bathroom/kitchen car/airplane cat/dog

E. Locatives (sobre/en/encima, debajo/abajo, detrás/atrás) Prompt: Play hide and seek with a variety of objects (doll house) and ask the child where the objects are. F.

Plural, third-person subject pronouns and possessive constructions Prompt: Game of Who has _____? Whose is _____? and What does _____ have? Plural: Prompt: Qué tienes/tengo? /s/ morpheme carro plato taza/vaso mesa silla Third-person pronoun:

/es/ morpheme botón lápiz papel avión tenedor

Prompt: Male and female dolls will participate as third-person referents in game: ¿Quién tiene (object)? Possessive construction: Prompt: Using male and female dolls, ask: ¿De quién es (object)? Source: Reprinted with permission from Assessing the grammar of Spanish-speaking children: A comparison of two procedures by R. T. Anderson. Language, Speech, and Hearing Services in Schools, 27, 333–344. Copyright © 1996 by American Speech-Language-Hearing Association. All rights reserved.

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Family and community members can aid an SLP in assessing performance, especially in the language sample (Bleile & Wallach, 1992; T. Campbell & Dollaghan, 1992). In one study, African American Head Start teachers were asked to judge children with poor speech and those with typically developing speech (Bleile & Wallach, 1992). The poor-speech samples were analyzed, and a set of community standards derived. Similar but more stringent social validation has been accomplished by using direct magnitude estimates (DME) of subjective judgments. In DME, stimuli are scaled by assigning numerical values to them on the basis of their relative magnitude along some continuum. Each child’s language speech sample is rated against a standard, the language of a child with no language impairment. If raters listen to several children and score them against a taped standard, they can begin to form a continuum of performance. For stability of scoring, at least ten listeners are required. Performance of a single child can be compared over time to measure improvements and can be compared with others by using the same dialect to assess overall performance. Obviously, child-centered sampling has the potential of reducing the impact of biases found in testing. Performance will vary across different language tasks. For example, 4- to 6-year-old speakers of African American English (AAE) use more AAE forms on picture description tasks than in free play (Washington, Craig, & Kushmaul, 1998). Because even heavily dialectal speakers use dialectal forms on only about 20 percent of words, sample analysis should focus on nondialectal components (Craig & Washington, 2002). The shared features of AAE and Standard American English may be more diagnostically important in assessing language impairment among African American children speaking AAE (Seymour, Bland-Stewart, & Green, 1998). SU M MARY Despite the incredible difficulties inherent in assessing children with CLD backgrounds, there is hope. The same integrated, functional methodology proposed for native speakers of English can be used with some modifications with these children as well. With sensitivity, unbiased administration of testing, and sampling within the everyday context of a child, a fair and meaningful assessment can be accomplished.

Conclusion Unfortunately, sometimes a battery of readily available tests is given to every child regardless of possible language impairment. This passes for an individualistic and thorough assessment. As with intervention, assessment procedures must be designed for the individual client. Standardized tests are only a portion of this process. Language tests are only aids to an SLP and cannot substitute for the informed clinician. A thorough assessment includes a variety of flexible procedures designed to heighten awareness of the problem and enables an SLP to delineate more clearly the language abilities and impairments of the child with a CLD background. For training to be truly functional, a thorough description of a child and that child’s language must be made.

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lthough tests are good for assessing global change, they miss many small or subtle behaviors. Language sampling provides more specific information for planning intervention because it includes both the content and context of language use. If the goal of language intervention is generalization to the language used by a child in everyday situations, it is essential that an SLP collect a language sample that is a good reflection of that language in actual use. And that’s what we’re going to learn to do. It is important that some portion of the sampling be accomplished in real communication situations (Olswang, Coggins, & Timler, 2001). In general, the processing demands of contrived situations are fewer than in real-life interactions. With the increased demands and multiple cues of natural situations, the language performance of many children with LI will deteriorate. As demands increase, the cognitive and linguistic resources available to process them change. Within real communication, the variables include the structure of the interaction, the number of individuals involved, distractions, and the immediacy and complexity of the language being received and produced. If we are going to program for use within a child’s natural communication contexts, then we must assess within those same contexts. So all these variables are present. Good language samples do not just occur. They are the result of careful planning and execution. An SLP can design the assessment session so that the context fits the purpose of collecting the desired sample. The result is usually a combination of free conversation sampling and some evocative techniques. Both are essential. For example, children with autism perform poorly on both standardized tests and spontaneous language samples (Condouris, Meyer, & Tager-Flusberg, 2003). With these children, evocative techniques may be crucial. An SLP must make several decisions before collecting the sample. After studying the interview, observational, and testing results, decisions must be made relative to the context, participants, materials, and conversational techniques to be used. It should be remembered that “there is no way to ‘make’ children talk . . .[the SLP] can only make them want to talk by creating a situation in which there is a reason to talk and an atmosphere that conveys the message that . . .[the SLP is] interested in what they have to say” (Lund & Duchan, 1993, p. 23). In this chapter, we cover the planning, collection, recording, and transcription of conversational samples.

Planning and Collecting a Representative Sample Several issues are of importance when planning and collecting our language sample. Among the most prominent are the representativeness of the sample and the effect of conversational context. In addition, collection of several language forms and functions may require the use of evocative techniques. All of these issues are important for children with language impairments and also for children with CLD backgrounds. R E PR ESE NTATIVE N ESS Representativeness or typicalness can be addressed by ensuring spontaneity and by collecting samples under a variety of conditions. Spontaneity can be achieved if a child and a conversational partner engage in real conversations on topics of interest to the child. To ensure spontaneity, an SLP can follow the (LCC)3 formula for (a) less clinician control, (b) less clinician contrivance, and (c) a less conscious child (Cochrane, 1983).

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An SLP’s control of the context should be weak so as not to restrict a child’s linguistic output in quantity or quality. Although there is some indication that SLP style has little effect on gross measures, such as average or mean utterance length, more subtle measures may be affected to a greater degree. Control devices, such as the use of questions and selection of topics by the SLP, may cause a child to adopt a passive conversational role and contribute little. When a child will participate freely and willingly, other, more structured approaches may be required. For example, an SLP can elicit longer and more complex language from young children with picture interpretation tasks than with imperatives or story recitation. In storytelling, the use of pictures can enhance the length and complexity of the sample, especially if an SLP gives cues, such as “Tell me a story about this picture. Begin with ‘Once upon a time.’ ” The least spontaneous condition involves the specific linguistic tasks of answering questions or completing sentences. The effects of each technique will vary with each child. An SLP can relinquish some control by placing these tasks within a less formal or play format. The sample will be less contrived if the SLP follows the child’s lead and adopts the child’s topics for conversation. More contrived situations, such as “Tell me about this picture” or “Explain the rules of Monopoly,” do not elicit spontaneous everyday speech. The most contrived situation occurs when an SLP relies on a tried-and-true, never-fail list of standard questions used with every child. Finally, if a child is less conscious of the process of producing language, the sample will be more spontaneous. Asking a child to produce sentences containing certain elements, for example, makes the linguistic process very conscious and may be very difficult, especially out of context. Although a child may not be able to produce a sentence with has been on demand, the same child may be able to relate the story of the three bears with “Someone has been sleeping in my bed.” The former task requires metalinguistic or abstract linguistic skills that may be beyond the child’s abilities. A child’s caregivers can offer suggestions to the SLP on contexts to help obtain a representative sample. It may be desirable for caregivers to serve as partners, especially with young children. After the sample has been collected, caregivers can review the data and comment on the typicality of their child’s behavior. A VAR I ETY OF LANG UAG E CONTEXTS The sampling environment can contribute to representativeness if there is a variety of contexts, including various settings, tasks, partners, and topics. Context is dynamic and complex, and the effects are very individualistic. One child may respond well to a certain toy and partner, while another child does not. Yet, the effects of context are not often considered in language assessment. Contextual variables include the task or purpose of the activity, the opportunities to use language, the extent of ritualization in the event, the amount of joint attending, and the responsivity of the partner (Coggins, 1991). The task itself, as previously noted, can affect both the number and length of the conversational interactions (Conti-Ramsden & Friel-Patti, 1987). For example, young children are more referential, attempting to focus the listener’s attention in free play, and are more information seeking in book activities (Jones & Adamson, 1987). Similarly, parents are influenced by context and engage in more conversation when playing with dolls than they do with cars and trucks (O’Brien & Nagel, 1987). The opportunities to use language will vary and may need to be provided. Although specific elicitation tasks, described later, may work for older children, they may not be effective with toddlers (Coggins, Olswang, & Guthrie, 1987).

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Two aspects of context are structure and predictability (Bain, Olswang, & Johnson, 1992). Structure is the amount of adult manipulating of materials and evoking of particular utterances. Predictability is the familiarity of the overall task and materials. In general, children will produce a greater frequency and diversity of language features in low-structure situations and more new features in predictable ones (Bain et al., 1992). Free-play sampling contexts have both low structure and predictability. Possibly in such low-structure contexts, children assume that the adult knows very little about the situation. In restrictive, planned contexts, children may assume that the adult knows more, and thus children say less. Routinized events or routines provide mutually understood and conventionalized interactions. In routines, the partner provides order for the child, who, in turn, depends on the partner’s cuing. This informal, predictable structuring allows for a child’s maximum participation by providing scripts (Platt & Coggins, 1990). Scripts are linguistic and nonlinguistic patterns that accompany routines, such as “How are you?—Fine, thanks. How are you?” Scripts reduce the amount of cognitive energy required for a child to participate. In general, children produce fewer topics and fewer contingent or related utterances in “low-script” or unfamiliar contexts (Conti-Ramsden & Friel-Patti, 1987). An attentive, responsive partner will elicit more language from child. In joint, or shared, attention situations, children produce more extended conversation and are best able to determine the meanings and intentions of the partner (Snow, Perlman, & Nathan, 1987; Tomasello & Farrar, 1986). Similarly, timely responses by a partner increase a child’s understanding because there may be as little as a onesecond interval after a young child’s utterance when he or she can still perceive the relatedness of the partner’s following utterance. As stated, a child’s performance will vary with the amount of contextual support. This variability is important in considering intervention targets and methods (Coggins & Olswang, 1987; Olswang, Bain, & Johnson, 1990). Variety ensures that the sample will not be gathered in one atypical situation. Instead, variety can reflect a sampling of the many interactional situations in which a child functions. Although variety is desirable, it is not always practical, especially in the public school setting. Audio samples collected by the parent or teacher can provide an acceptable substitute. Settings and Tasks The best sampling context is a meaningful activity containing a variety of elicitation tasks. In general, a child who is more familiar with the situation will give the most representative sample. As mentioned, familiar routines provide a linguistic and/or nonlinguistic script that guides a child’s behavior. For young children, play with familiar toys and partners is one of these routine situations. Language is a natural part of many routine events. An SLP needs to decide whether a child’s typical or optimal production is desired. In general, young children engaged in free play produce more utterances than those telling stories; however, both story generation and conversation result in more complex syntactic structures than free play (Southwood & Russell, 2004). The differences in play and language behaviors of children with LI in various play situations with assorted partners emphasize the need to evaluate these children in multiple play and conversational situations with several different partners (DeKroon, Kyte, & Johnson, 2002). Although story generation elicits longer utterances than either free play or conversation, the context of story generation varies. While TD children in kindergarten and second grade provide more information when they are retelling a story than when telling the same story from pictures alone, the use of pictures in narrative elicitation tasks seems to increase average utterance length for adolescents with Down syndrome who need the extra input (Miles, Chapman, & Sindberg, 2006; Schneider & Vis

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Dubé, 2005). For some children at least, wordless picture books seem to be a good resource for eliciting narratives. On the other hand, direct questions elicit the greatest number of different words (Gazelle & Stockman, 2003). Although question type does not seem to influence mean length of utterence (MLU) in toddlers, preschoolers respond with more multiword utterances following open-ended (What should we do next?) and topic-continuing questions (de Rivera, Girolametto, Greenberg, & Weitzman 2005). Settings should not be too contrived. Familiar, meaningful situations with a variety of ageappropriate and motivating activities provide greater variety and thus are more representative. Good settings for preschoolers include the free play mentioned earlier, snack time, and show-and-tell. Schoolage children can be sampled during group activities, class presentations, conversations with peers, and field trips. Generally, a child involved in some activity produces more language than a child who is watching others or conversing about pictures. It is better if the sample consists of two different settings in which different activities are occurring. The challenge for an SLP is to find a collection technique that strikes a balance. Too highly structured methods often are not representative (Fujiki & Brinton, 1987). Free play, although low in structure, may be time-consuming and result in variable unreliable data. It has been suggested that for older children, an interview technique is an effective alternative (Dollaghan, Campbell, & Tomlin, 1990). For 8- to 9-year-old children with SLI, the interview technique, although continued, yields more and longer utterances, more complex language forms, more temporal adjacency and semantic contingency, and more reliable, less variable results than free play (Craig & Evans, 1992). Conversational sampling should be authentic and functional (Damico, 1993). Authenticity comes from the use of real communication contexts in which the participants convey real information (Crystal, 1987; Damico, Secord, & Wiig, 1992; Douglas & Selinker, 1985). Functional sampling is most concerned with the success of a child with LI as a communicator. Success can be measured by effectiveness in transmitting meanings, fluency or timeliness, and appropriateness of the message form and style in context (Damico, 1991a; Kovarsky, 1992). The materials used should be interesting, age appropriate, and capable of eliciting the type of language desired. Interest can be piqued if a child is allowed to choose from a preselected group of toys or objects. Parents also can bring a their child’s toys from home in order to increase the validity of the sample. The selection of clinical materials can affect the pragmatic performance of young children by modifying the physical context in which the sample is collected (Wanska, Bedrosian, & Pohlman, 1986). This selection is especially important, given the current emphasis on the use of play in pragmatic assessment and intervention. When no toys are present, children are more likely to initiate memory-related topics (Bedrosian & Willis, 1987). In general, children around age 2 respond well to blocks, dishes, pull and wind-up toys, and dolls. Children around age 3 prefer books, clothes, puppets, and such toys as a barn with animals or a street with houses and stores. These toys encourage role-playing and language production. Kindergarten and early elementary school children respond best to toys with many pieces and to puppets and action figures. Finally, older children usually converse without the use of objects and can be encouraged to talk about themselves and their interests or to provide narratives. Narratives, a special type of language production, are discussed in Chapter 8. An SLP should consider the nature of the toys to be used in a play assessment (Wanska et al., 1986). For example, toys with construction properties, such as Legos, Play Doh, or clay, might be used to determine whether a child can remove the conversation from the present. Such toys are more likely to elicit more displaced topics, especially as objects are being constructed (R. S. Chapman, 1981).

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On the other hand, toys that encourage role-play might be used to elicit more verbalizations or vocalizations for objects, events, and actions. Compared with construction-type toys, a toy hospital elicits more discussion of the here and now and more fantasy topics and is more conducive to sociodramatic play and verbal representations of events and actions (Wanska et al., 1986). Toys also may assist in eliciting specific linguistic structures. For example, children are more likely to produce spatial terms in play with objects than in conversation. Object movement and manipulation can serve as nonlinguistic cues for a child. Because children’s cognitive knowledge and linguistic performance of spatial relationships may differ markedly, manipulation of toys can aid an SLP in assessing a child’s comprehension (Cox & Richardson, 1985; Harris, Morris, & Terwogt, 1986). The toys and positions should be varied so as not to suggest answers to children (Messick, 1988). If certain language features are desired, an SLP must increase the probability of their occurrence. With school-age children, discussion, rather than conversations based on pictures or toys in context, yields more mature language as measured by clause structure complexity, the ratio of hesitations to words, and grammatical and phonemic accuracy (Masterson & Kamhi, 1991). Because of the more complex language required in peer conflict resolution, these problems hold promise as a language sampling and intervention milieu for adolescents (Nippold, Mansfield, & Billow, 2007). In one model, a client is read a scenario concerning conflict between two young people. After this presentation, the client is asked to retell the scenario and to answer a series of questions on the nature of the conflict, why it’s a problem, and how it might be resolved by each character. Conversational Partners Because the SLP is interested in a child’s use of language, the unit of analysis becomes the conversational dyad of the partner and the child and their interactive behaviors in a given context (Prutting & Kirchner, 1983). The dyadic context enables an SLP to view a child’s communication within the applied situation of the natural environment. The importance of different partners is evident when we consider the conversations of adolescents. When teens talk to peers, they ask more questions, obtain more information, shift to more new topics, use more figurative expressions, and make more attempts to entertain than when they talk with their families (Nippold, 2000). Specific partners influence all aspects of communication. Conversational partners for young children should be carefully selected and instructed in their role. It is especially important to use familiar conversational partners with children under age 3 because these children often respond poorly to strangers. Parents of young children or children with acknowledged disabilities may need special instruction to avoid having their children “perform.” Uninstructed parents may feel compelled to quiz their child or to have their child recite stereotypic verbal routines such as nursery rhymes to enhance the child’s linguistic output. The problem with such recitations is that they may have little to do with the conversational abilities of a child. In general, it is best to involve a parent or caregiver and a child in some activity. Caregivers can be instructed to talk about what they and the child are doing. As mentioned, toys such as doll houses, action figure play sets, farms and towns, and puppets encourage interaction and role play. Familiar conversational situations are chosen as well to attain the most typical spontaneous sample in which a child is conversing as naturally as possible. Interaction may involve one adult or child or a small group of children engaged in sharing, playing, or working in the home or the classroom. A child should be assessed across several familiar persons with different interactive styles because of the effect that conversational partners—either individually or in small groups—have on the child’s

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verbal output (Mirenda & Donnellan, 1986). For example, peer interaction usually involves more equal status between participants than do adult–child interactions. Adults tend to guide and control the topic when conversing with children, whereas child–child conversations are presumably more equal. As one might expect, these two conditions result in very different interactive styles for a child. If two children are talking, the adult should leave the room because children who are unsure of the situation will defer to the adult and thus skew the data. The language performance of children below age 3, of minority children, and of children with LD may deteriorate in the presence of an authority figure such as an unfamiliar adult. This does not mean that an SLP cannot act as a conversational partner. In many ways, an SLP may be the best conversational partner because of his or her knowledge of language and of interactions. The SLP and all other participating adults need to be mindful of the inherent problems in adultchild conversations and act to reduce the authority figure persona. The adult can accomplish this by accepting the child’s activity, agenda, and topics and by participating with the child. The best way to attain a semblance of equal authority is for the SLP and the child to engage in a play interaction. Instead of being directive, the SLP comments on and participates in their ongoing shared activity. With young children, participation may necessitate using the floor for play. As the conversational partner, the SLP can set the tone of the interaction by being nondirective, interesting, interested, and responsive. The SLP should respond to the content of the child’s language, not to the way it is said. At this point, the purpose is to collect data, not to change behavior. Our goal is collecting, not correcting. By manipulating the situation skillfully, an SLP can probe for a greater range of information. Initially, interaction may be dampened because the SLP is not the child’s usual communication partner. Therefore, it is important for the SLP to get acquainted slowly and in a nonthreatening manner. This task is best accomplished by meeting a child on his or her terms through play and by following the child’s lead. SLPs possess the clinical skill to elicit a variety of functions, introduce various topics, and ask questions about experiences. Role-play, dolls, and puppet play provide information about a child’s event knowledge in a range of situations. There is the potential to elicit a greater variety of language than might be possible when the child and parent communicate. Children who are reluctant to talk to adults may be more willing to interact with a puppet or a doll. I have found that small animals, such as guinea pigs, make excellent communication partners for children. For example, after explaining to a child that she must leave to run a short errand, the SLP introduces the guinea pig and asks the child to talk to it so that it will not get lonely. The child should be observed and his or her language recorded while the SLP is absent. Despite conventional wisdom, neither the race of the conversational partner nor the race depicted in stimulus materials seems to affect language performance as measured by response length and response latency (H. Seymour, Ashton, & Wheeler, 1986). This is not to say that all children, particularly children with CLD backgrounds will be unaffected. SLPs should be aware of potential difficulties and should approach each child with an open mind. Racial incompatibilities should not be expected, but all SLPs should be conscious of this potential. Topics Children have a wide variety of interests, and the conversational partners must be careful to enable a child to talk about them. Children are more spontaneous and produce more language when they are allowed to initiate the topics of discussion.

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An SLP should be prepared to shift topics as readily as activities. Therefore, an SLP must be conversant in topics of interest to children, such as school activities, holidays, movies, television programs, fads and fashions, videogames, and music. Summary Child variables, such as recent past experience and mood, can greatly affect language sampling, because the child is often the initiator in this protocol and because there are few performance constraints (Hess, Sefton, & Landry, 1986; Klee & Fitzgerald, 1985). To get the most representative sample possible, therefore, an SLP should use familiar situations, persons, and tasks or topics. Representativeness is enhanced if the conversational sample is collected in more than one setting, with different conversational partners and tasks or topics in each. Guidelines are summarized in Table 5.1. It may be helpful to think of interactional situations along a continuum from relatively nondirected or free to more controlled or scripted (Coggins, 1991; Shriberg & Kwiatkowski, 1985). Such toys as a dollhouse, a farm, action figures, bubbles, or dress-up clothes are rather open-ended, especially when a partner has suggested, “Let’s talk and play with these things.” Books or Colorforms offer more control and can be used to elicit particular words, forms, and narratives. Familiar routines, such as doing the dishes, also can be used, along with such cues as “What are you going to do now?” to elicit more specific behavior. Interviews, picture labeling, and responding to questions offer the most control but at the sacrifice of spontaneity and representativeness. These latter techniques are more appropriately considered evocative techniques used to elicit specific behaviors. Table 5.2 presents contextual variables that can be manipulated in an assessment to influence a child’s performance. Each variable can be modified to offer minimal or maximal contextual support (Coggins, 1991). Sampling should engage children in challenging interactions that stretch their language and reveal deficits (Hadley, 1998b). This requires a range of interactive situations and discourse types, including conversation, play, narration, and expository or factual/causal communication. EVOCATIVE CONVE R SATIONAL TECH N IQU ES Although the sample should represent everyday language use, free samples may have limitations, such as low frequency or nonappearance of certain linguistic features and conversational behaviors (F. Roth & Spekman, 1984b). Absence or low incidence does not mean a child lacks these features or behaviors. Therefore, it may be necessary to supplement the sample with evocative procedures specifically designed to elicit them. Test protocols also might be modified to obtain more structured samples (Thomas, 1989). An SLP may need to plan both the linguistic and nonlinguistic contexts for elicitation of various functions and forms. This requires planning and forethought. For example, infinitive phrases not only TABLE 5.1

Ensuring Representativeness in a Conversational Sample

Keep it spontaneous

Variety

Less clinician control

Settings

Less clinician contrivance

Tasks

Less conscious child

Conversational partners Topics

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Continuum of Contextual Support

Variable

Minimal Contextual Support

Maximal Contextual Support

Nonlinguistic Interaction Materials Interactor Activities

Naturalistic No toys or props Clinician Novel

Contrived tasks Familiar and thematic Mother/caregiver Event routines

Linguistic Cuing

Indirect model

Elicited imitation

Source: Coggins, T. E. (1991). Bringing context back into assessment. Topics in Language Disorders, 11(4), 43–54. Reprinted with permission.

are difficult for children with LI but they also require specific evocative techniques (Eisenberg, 2005). Infinitives come in two varieties, noun-verb-to-verb (John wants to go) and noun-verb-noun-to-verb (John wants Fred to go). An SLP can use play with dolls or puppets and have a child complete sentences within the play in the following manner: The cat says, “Can I eat?” The cat wants . . . You finish the story. The cat . . . ? The boys says to the girl, “Swim with me.” The boy asks . . . You finish the story. The boy . . . ? Early developing infinitives accompany verbs such as ask, forget, go (gonna), have (hafta) (gotta), like, need, say, suppose, tell, try, use, want. At first, some procedures may seem stiff and formal, even forced. Initially, the SLP may need to role-play the sampling situation and memorize conversational openers and replies. Once familiar with the many ways of eliciting a variety of functions and forms, an SLP can relax and use the techniques more naturally as opportunities arise within the interaction. Specific tasks that are within a child’s experience also can be used to elicit specific language forms (F. Roth & Spekman, 1984b). This approach allows a broad range of pragmatic functions to occur. For example, a mock birthday party can be used to elicit plurals, past tense, and questions (Wren, 1985). The SLP might elicit plurals by saying the following: Today is X’s birthday. Let’s have a party. What are some things we’ll need? (Or, Here are some things we need. What are these?) The child’s utterances are placed within context in which they make sense. Within the same situation, past tense might be elicited by dropping dishes and asking what happened or by reviewing whether you did everything to get ready (“Okay, now tell me what you did to get ready for the party. I washed the dishes”). Finally, questions can be elicited by a party game variation of Ask the Old Lady. Let’s play a question game. This is X (puppet, doll, action figure). I want you to ask X some questions about his birthday party. I wonder how old he is. You ask him. The child may need a demonstration before being able to complete the question task. Specific procedures and activities can be used to elicit a variety of communication intentions, examples of presupposition, and the underlying social organization of discourse within a variety of

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Situations with the Potential to Elicit a Variety of Language Functions

Dress-up

Role-playing

Playing house or farm

Playing school

Dolls, puppets, adventure or action figures

Acting out stories, television shows, movies

Farm set or street scene

Imaginary play

Simulated grocery store, gas station, fast-food restaurant, beauty parlor

Simulated TV talk show

situations. Table 5.3 lists examples of situations that each elicit a variety of language functions. In addition, SLPs are interested in ways to elicit various semantic and syntactic features. These elicitation techniques are presented in the following section. Intentions or Illocutionary Functions Illocutionary functions are the intentions of each utterance. Most utterances clearly demonstrate the speaker’s intent. “What time is it?” demonstrates a desire for information. However, the relationship is not always so obvious. “What time is it?” might be used as an excuse. For example, the speaker who does not wish to do something and knows that time is limited might use this utterance to establish the time factor for other people. Well, I don’t know . . . , it’s getting late. What time is it? Oh, well, I really better be going. Utterances also may express more than one intention. For example, the speaker might respond to a piece of art with “What do you call that thing?” Here, the speaker requests information and also makes an evaluation. Scripted elicitation protocols can target several communication intentions and conversational devices within different structured activities. Table 5.4 presents an outline of the two protocols (Creaghead, 1984). Some intentions are responsive in nature, for example, answering a question or following a directive or request for action. In addition to a child’s production level of such requests, it is helpful to know the child’s level of response (F. Roth & Spekman, 1984b). With responsive functions, an SLP must not interpret noncompliance as noncomprehension. A child simply may not want to comply or may choose to ignore the request. My granddaughter is especially good at ignoring. Come to think of it, so was her mom. An SLP first should be certain that the child can perform the behavior requested. The ages at which children comprehend different levels of requests are listed in Table 5.5. It might be helpful for the SLP to use two children in an ask-and-tell situation so that each child can act as a model for the other. In a similar manner, an SLP and child can switch roles as questioner (or director) and respondent. These are just a few suggestions for eliciting a variety of communication intentions. An SLP must note the type of intentions displayed, their forms, the means of transmission, and the social conventions that affect these means. For example, some situations may call for the use of nonverbal means; others may not. The following are a broad range of intentions and accompanying activities that may elicit language functions or intentions within a conversational or situational context.

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Elicitation Protocol for Communication Intentions and Conversational Devices

Test Procedures—Format 1

Test Procedures—Format 2

As child enters the room—check GREETING Have cookies and crackers in jar within child’s view but out of reach—check REQUEST FOR OBJECT Hand child the tightly closed jar containing the cookies—check REQUEST FOR ACTION (help opening the jar) Ask child, “How do you think we can get the jar open?”—check HYPOTHESIZING Say “Do you want ‘mumble’?”—Check REQUEST FOR CLARIFICATION Ask the child if he or she wants peanut butter or jelly on a cracker—check MAKING CHOICES Hand the child the opposite of what was chosen— check DENIAL Put the peanut butter and jelly on the table. Ask the child, “What are we going to do now?”— check PREDICTING Tell the child to put peanut butter or jelly on the cracker—check REQUEST FOR OBJECT (knife) Tell the child to get the knife, which is not in sight— check REQUEST FOR INFORMATION Put the peanut butter and/or jelly on the cracker and eat it. Get out extra big toothbrush and pretend to brush teeth—check COMMENT ON OBJECT Hold a conversation with the child. During this, pull invisible string so that my doll falls off the table—check COMMENT ON ACTION Ask the child, “What happened?”—check DESCRIBING EVENT Ask the child, “Why did it fall?”—check GIVING REASON During conversation—check ANSWERING, VOLUNTEERING TO COMMUNICATE, ATTENDING TO THE SPEAKER, TAKING TURNS, ACKNOWLEDGING, SPECIFYING A TOPIC, CHANGING A TOPIC, MAINTAINING A TOPIC, GIVING EXPANDED ANSWERS Stop leading the conversation and be silent—check ASKING CONVERSATIONAL QUESTIONS Request clarification—check CLARIFYING

As child leaves the room—check CLOSING Give the child and yourself a piece of paper and tell the child to draw “mumble”—check REQUEST FOR CLARIFICATION After clarifying, do not give the child a crayon—check REQUESTING AN OBJECT Ask the child if he or she wants a red or blue crayon— check MAKING CHOICES Put on big glasses and then show the child a picture of a person and call it a dog—check COMMENTING ON OBJECT and DENIAL Ask the child, “Do you want to play with ‘mumble’?”— check REQUEST FOR CLARIFICATION Tell the child to get the telephones, which are not in sight—check REQUEST FOR INFORMATION Ask the child, “What are we going to do?”—check PREDICTING The tester calls the child, then the child calls the tester on the telephone—check GREETING and CLOSING Hold a conversation with the child. During this, make a remote-controlled toy move. The toy should be out of the sight of the tester and covered with a cloth— check COMMENT ON ACTION Ask the child, “What happened?”—check DESCRIBING EVENT Ask the child, “What do you think is under the cloth?”— check HYPOTHESIZING Ask the child, “Why did it move?”—check GIVING REASON Make the toy move briefly—check REQUEST FOR ACTION During conversation—check ANSWERING, VOLUNTEERING TO COMMUNICATE, ATTENDING TO THE SPEAKER, TAKING TURNS, ACKNOWLEDGING, SPECIFYING A TOPIC, CHANGING TOPIC, MAINTAINING A TOPIC, GIVING EXPANDED ANSWERS Stop leading conversation and remain silent—check ASKING CONVERSATIONAL QUESTIONS

Note: These protocols may be used as suggested scripts for efficient elicitation of several communication intentions and conversational devices. Source: Creaghead, N. (1984). Strategies for evaluating and targeting pragmatic behaviors in young children. Seminars in Speech in Speech and Language, 5, 241–251. Reprinted with permission.

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TABLE 5.5 Age in Years

Communication Assessment

Age and Comprehension of Requests

Comprehension

2

I need a _______. Give me a _______.

3

Could you give me a _______? May I have a _______? Have you got a _______?

4

He hurt me. (Hint) The _______ is all gone. (Hint)

41⁄2

Begin to comprehend indirect requests: Why don’t you _______ or Don’t forget to _______. Mastery takes several years.

5

Inferred requests in which the goal is totally masked are now comprehended. In this example, the speaker desires some juice: Now you make breakfast like you’re the mommy.

Source: Adapted from Ervin-Tripp (1977).

Answering/Responding An SLP asks a child a variety of questions while engaged in play (“Where shall we put the houses?”“Who is that?”“What’s in his hand?”) and notes the type of question and the expected response. Some question forms may be easier or more difficult for a child to respond to. Calling/Greeting An SLP leaves and reenters the situation, role-plays people entering and leaving a business, calls on the telephone, or uses dolls, puppets, or action figures to elicit greetings. If the SLP turns away from the child with a favorite toy, the child also may call. Continuance Continuance is turn filling that lets a speaker know that a listener is attending to the conversation. Typical continuants include “uh-huh,” “yeah,” “okay,” and “right.” These can be observed throughout the session. The SLP notes when the child seems to rely on this function, rather than contribute anything new or relevant to the conversation. Expressing Feelings An SLP models feeling-type responses throughout the play interaction. Dolls, puppets, or action figures are described as having certain feelings and the child is asked to help. For example, the SLP could say, “Oh, Big Bird is sad. Can you talk to him and make him feel better?” Hypothesizing An SLP poses a physical problem for a child, such as,“How can we get everyone to the party on time?” or, “How can we get Leonardo out of the cage?” The child proposes solutions to the problem. Making Choices An SLP presents a child with alternatives, such as,“I don’t know whether you’d rather have a peanut butter sandwich with jelly or fluff.” Predicting In sequential activities or book reading, an SLP can ponder, “I wonder what will happen now” or, “I wonder what we’ll do next.” Protesting An SLP can elicit protesting by putting away toys or taking away snacks before the child is finished. When a child requests an item, an SLP can hand the child something other than what was requested.

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Reasoning An SLP attempts to solve a problem, such as, “I wonder why the boy ran away” or, “I wonder what we did wrong.” Repeating An SLP should note the amount of repetition of self and of the partner. This can take the form of empty comments in a conversation in which a child adds no new information, for example: Adult: Did your class go to the zoo yesterday? Child: Yeah, zoo. Adult: What did you like best? The monkeys? Child: Monkeys. Adult: Monkeys are my favorite too. They’re so funny. Child: Monkeys funny. Replying An SLP should note occasions when a child responds to the content of what he or she has said without being required to do so. This behavior is one of the mainstays of conversation as each speaker builds on the comment of the previous speaker. Reporting Reporting can include several functions. Declaring/Citing. While engaged in an activity, a child spontaneously comments on the present action. The SLP can model this behavior (“Car goes up the ramp”) but not attempt to cue a response because declaring/citing is spontaneous. The SLP also can engage in unexpected or unusual behavior and await the child’s comment. Detailing. An SLP presents a child with two objects of different size or color. If the child takes one and says nothing, the SLP models (“I’ll take the little one” or “Here’s a green truck”) and presents other objects later. The SLP does not attempt to cue a response because detailing is also spontaneous. Naming/Labeling. An SLP presents a novel object or points to pictures in a book and remarks,“Oh, look.” If the child does not label the object or picture, the SLP models the response (“Look. A clown.”) and goes on. The child may do so on subsequent exposure to other novel objects. The SLP does not cue a response because labeling like the other forms of reporting should be spontaneous. Requesting Assistance/Directing An SLP presents interesting toys in a way that requires adult help to open or use, such as objects in clear plastic containers or drawstring bags that require help to open. • Placing Giving the child one portion of a toy while keeping the other on a shelf. • Letting windup toys run down. • The SLP makes such comments as,“I wish we could play with this; it would be fun,”“Oh, we could use more parts,” or “Gee, we need to fix that.” In another situation, the child helps two puppets or dolls solve a problem in which one will not share a special toy with the other. The SLP also can present the child with situations that require a solution, such as toys with missing pieces. During interactions the SLP should note self-directing or self-talk accompanying play. This behavior can be modeled for the child, but it should be spontaneous on the child’s part. Requesting Clarification This intention can be elicited when an SLP mumbles or makes an inaccurate statement.

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Requesting Information An SLP places novel but unknown objects in front of a child. Naming the object correctly is the naming labeling function and the SLP should confirm the child’s name. If the child labels incorrectly, the SLP says, “No, it’s not an X,” “No, can you guess what it is?” or “How can we ask what it’s called?” The responses “What’s that?” or “What?” and those with rising intonation (“Frog?”) should be considered requests for information. The child can also be directed to ask others. Requesting Objects An SLP exposes the child to enticing objects or edibles that are just out of reach. The SLP also might direct the child to use an object not present in the situation or not in the expected location. If prompting is required, the SLP can ask,“Do you have the scissors?”When the child answers negatively, the SLP can direct the child by saying, “Ask Sally if she does.” Requesting Permission An SLP hands an interesting object to a child and says, “Hold the X for me.” The technique is more effective if the SLP uses a nonsense name for the object. The SLP then awaits a response from the child, such as, “Can I play with X?” or just, “Play X?” An even more effective technique is to keep the object hidden in an opaque box. The SLP peeks into the box and tells the object that it can come out to play when someone wants to play with it. If necessary, a puppet can model the requesting behavior desired. Presuppositional and Deictic Skills Whereas intentions are noted at the individual level, other linguistic aspects, such as presupposition and deixis, underlie the entire conversational interaction. Presupposition is the speaker’s assumption about the knowledge level of the listener and the tailoring of language to that supposed level. Deixis is the interpretation of information from the perspective of the speaker. When a speaker says, “Come here,” this must be interpreted as a point close to the speaker, not as a point with reference to the listener. Deictic terms include, but are not limited to, here/there, this/that, come/go, and you/me. Presuppositional and deictic skills can be assessed in referential communication tasks (F. Roth & Spekman, 1984b). In classic referential tasks, one partner describes something or gives directions to the other partner, who is usually on the other side of an opaque barrier or unable to see the speaker (see Figure 5.1). Variations include blindfold games or telephone conversations. As a rule, preschoolers perform better if describing real objects rather than abstract shapes. Deixis can be elicited by using objectfinding tasks in which the child directs the conversational partner toward a hidden object. In these tasks, an SLP must be alert to the use of direct/indirect reference. In direct reference, the speaker considers the audience and clearly identifies the entity being mentioned. Indirect reference typically follows direct reference and refers to entities through the use of pronouns or such terms as that one. A child with poor presuppositional skills may use indirect reference without prior direct reference. Additional presuppositional information can be gathered by varying the roles, topics, partners, and communication channels available in the sampling situation. Roles can be varied so that a child has an opportunity to act as listener and speaker. Assessment of both roles is essential. For example, a child with LD generally will ask few questions for clarification even when he or she has little understanding of what has been said. As speakers, these children make limited use of descriptors, provide very little specific information, and are less effective than children developing normally. The choice of topics also can influence presuppositional behavior and provide for a variety of role taking. Children can be asked to describe events about which the SLP or partner is ignorant (e.g., a family outing). In this situation, the child must determine the amount of information necessary for the listener to understand the topic. The partner who asks the child to explain something that the partner

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FIGURE 5.1 Barrier tasks.

already understands violates the principle that communication should make sense. There is no sense in explaining something that someone already understands. As the number of communication channels decreases, a speaker is forced to rely more heavily on the remaining ones. For example, the use of a telephone requires the speaker to rely almost exclusively on the verbal communication channel. This situation is a challenge even for some nonimpaired language users. While gathering the language sample, an SLP can manipulate channel availability systematically. During play, an SLP can look away and then ask the child to describe what he or she is doing. Barrier games or blindfold games with the child in charge also may elicit interesting information; however, roleplaying with the telephone is more realistic. Several other activities can be used to elicit presuppositional skills. Of interest is whether a child can encode the most informative or uncertain elements in a situation. In general, human beings tend to comment on entities and events that are new, changing, or unexpected. In the sampling situation, novel items can be introduced. The SLP must attend to the child’s behavior to see whether the child refers to the novel stimulus. I know of one clinic where a kitten is abruptly introduced into the sampling situation. The SLP says nothing but waits to see whether the child will comment and in what manner. In general, young children with LI encode novel information less frequently than do children developing typically. Older school-age children with LI tend to use more pronouns with less identification of the referent than do children developing typically. Games and stories can elicit indirect/direct reference. For example, a story can be told and then questions asked to elicit indefinite and definite articles and/or nouns and pronouns. The child also can retell a story to a second child who has not heard it. Any portion of extended discourse, such as describing a movie, explaining how to accomplish a task, or telling a story, will be valuable clinical data (F. Roth & Spekman, 1984b). The SLP is interested in both the lexical items used and the ambiguity of the referent. Of interest is the number of times the child mentions the referent by name or by the use of pronouns. Some children overuse the referent name (“The boy . . . , The boy . . . , The boy . . .”), whereas others rely on the pronoun without sufficient return to the referent name to avoid confusion (“He . . . , He . . . , He . . .”). Finally, role-playing activities with very specific situations also can be helpful. The child in the following situation faces very definite behavioral constraints.

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Imagine you and a friend are trying to find a drinking fountain. You see a man coming down the street. While your friend remains seated on a park bench, you try to find out about the fountain. I’ll be the man. What would you say? (Child responds.) Now, I’m your friend. What would you tell me? Discourse Organization Discourse has internal organization. For example, a telephone conversation has a recognizable pattern, as does the telling of a personal event. The social organization of discourse can be assessed within familiar activities that provide a scaffolding or structure for dialogue (F. Roth & Spekman, 1984b). An SLP may be interested in the amount of social and nonsocial speech. For example, preschool children frequently engage in nonsocial monologues in play, in contrast to older children, who participate more in dialogues or in social monologues. This change signals a growing awareness of the social nature of speech and language use. An SLP can provide opportunities for a child to initiate conversation, to take turns, and to repair in response to self-feedback or the feedback of others in different situations. Turn taking may need to begin at a physical level with some reticent children. In conversation, an SLP might even say, “Now it’s your turn,” and point to the child initially. By failing to respond to the child or by responding inappropriately, mumbling, failing to establish a referent, misnaming, or providing insufficient information, an SLP may elicit requests for clarification from a child. Semantic Terms Relational terms, such as in front of, more/less, and before/after, are especially difficult for children with LD and other forms of LI. These children often use comprehension strategies that have several implications for assessment (Edmonston & Thane, 1992). For locational terms, these strategies may include probable location, physical properties of objects, and preferred location. Adjectival relational words, such as big and little, may be comprehended by using either a preference for amount or word synonymity. With temporal terms, strategies may include sequential probability and order-of-mention or main-clause-first. Each of these strategies is explained below. It is easier for children to comprehend locational terms and to follow locational instructions when familiar objects are combined in familiar, predictable, or probable ways, such as juice in a cup. Levels of comprehension can be determined by using the usual, or “normal,” context or a “contextually neutral” context in which object placement is not so predictable (Lund & Duchan, 1993). The physical properties of an object can also influence responding. A child’s rule may be, Containers are for in, and surfaces are for on. Square containers can be turned on their sides by the SLP and used for both in and on. Other objects may be used with different terms (Edmonston & Thane, 1990). Some objects are fronted or have an obvious front, such as a TV, while others, such as a wastebasket, are not. This characteristic affects comprehension and production of such terms as in front of and behind. In general, these terms are easier to use with fronted objects than with nonfronted objects. In addition, some young children interpret behind to mean hidden from view by, so they will place a small object correctly with large nonfronted objects (J. Johnston, 1984). Obviously, in front of and behind must be assessed with fronted and nonfronted and small and large objects (Edmonston & Thane, 1992).

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With deictic terms, young children may employ either a child-centered or speaker-centered strategy, preferring that location as the reference point (Wales, 1986). Assessing contrastive terms, such as here/there, with different speakers may be help determine if such preferences exist. Adjectival terms, such as more/less, long/short, and big/little, may be interpreted by using a preference for a greater-amount strategy in which a child usually chooses the largest one when in doubt. Assessing both words in different contexts and in different word order may help an SLP understand a child’s errors. Similarly, height of the objects used affects comprehension of such words as big, tall, top, young, and old (Coley & Gelman, 1989; Harris et al., 1986; Hobbs & Bacharach, 1990; Sena & Smith, 1990). Preschoolers often equate big with tall and old and little with short height and young. Objects can be placed so that their heights are similar by using stands of different heights. Some children use a strategy in which they interpret contrastive terms such as big and little to be synonymous or assign the meanings to similar terms. In the latter, big becomes synonymous with tall, wide, and thick. Object dimensions can be controlled so that, for example, the widest objects are not always the biggest overall. Finally, as mentioned, temporal sequential terms, such as before and after, may be interpreted by using a most probable, order-of-mention, or main-clause-first strategy. In the most probable strategy, a child trusts experience. Among preschoolers, this is the most widely used strategy with familiar, realworld sequences (Keller-Cohen, 1987). Order-of-mention, or the first-action-mentioned-occurredbefore-the-second, is also popular among preschoolers, while children over age 5 often use the main-clause-first strategy in which the main clause of the sentence is assumed to have occurred first. For example, in the sentence “After finish school, we can go to the rec center,” a child may assume the rec center occurs first. Sequential terms should be note when used as both prepositions, as in after school, and conjunction, as in she did X after she did Y. Language Form An SLP can manipulate the context to elicit particular forms. For example, the objects and the verbal routines chosen for play may facilitate the use of pronouns or prepositions. Specific syntactic forms, such as verbs, and morphological markers, such as the regular past-tense -ed, also can be elicited in creative ways. Some intentions discussed previously in this chapter, such as requesting information, have specific linguistic forms. A few elicitation methods for specific structures are listed in Table 5.6 (Crais & Roberts, 1991).

LANG UAG E SAM PLI NG OF CH I LDR E N WITH CLD BACKG ROU N DS It is even more important that the language of children with CLD backgrounds be collected in several different contexts (Damico, 1991b; Iglesias, 1986). Code switching and differing language and dialect use in context is extremely important information for determining the effectiveness of a child as a communicator. Sampling should occur in monologue and dialogue situations in both languages or dialects. Monologue activities might include static, dynamic, and abstract tasks. Static tasks describe relationships among objects in the context and might include directing others to perform a task or describing entities by location, size, shape, or color. Dynamic tasks describe changes over time as in narration. Finally, abstract tasks might include opinion-expressing tasks, such as stating or justifying a position.

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TABLE 5.6

Communication Assessment

Elicitation of Some Language Features

Feature

Elicitation Technique

Prepositions Nouns, verbs, etc.

Hide objects and have the child try to guess their location. Ask specific Wh- type questions: What’s that? for nouns. Where’s X? for prepositions. What’s John doing? or What did (will) Mary do? for verbs. How does Carol feel? or How did Martin do X? for adjectives and adverbs. Play games with many parts, such as Mr. Potatohead or Colorforms and have the child request desired pieces (I want the ears). Use similar objects of different sizes and colors. Ask child, What do you want? Play dress-up and ask, Whose dress is this? Play I Spy (I spy something and he’s big). Play Twenty Questions and I Spy. Play Hide-and-Seek and other guessing games (What’s in the bag? Where’s the bull?).

Plural -s marker Adjectives Possessive pronouns Subjective pronouns Yes/no questions Wh- questions

Source: Crais, E. R., & Roberts, J. (1991). Decision making in assessment and early intervention planning. Language, Speech, and Hearing Services in Schools, 22, 19–30. Reprinted with permission.

Dialogue situations should include a variety of partners because of the special constraints that each imposes on a child with a CLD background. The classroom is especially important because of the academic difficulties these children may encounter. In each context, different conversational partners can pose communication problems for a child. Change and problem solving encourage communication and enable an SLP to determine the effectiveness of the child as a communicator. In addition, such situations can offer clues to the learning style of the child (Iglesias, 1986). Guidelines for collecting a language sample from children with CLD backgrounds are presented in Table 5.7.

Recording the Sample There is no ideal length for a conversational sample. Length varies with the purpose of collection. For example, a 50-utterance sample may be adequate for lexical evaluation because it will contain 73 to 83 percent of the lexical information found in a 100-utterance sample (Cole, Mills, & Dale, 1989). Although 50 or 100 child utterances are considered adequate, providing there is some variety of setting, partners, tasks, or topics and that other data collection methods are used, at least two different samples should be included (Cole et al., 1989). For example, one 15-minute or 50-utterance sample is insufficient for measuring Brown’s Fourteen Morphemes (Balason & Dollaghan, 2002). Remember them for your language development course? At best, even with two samples, an SLP may obtain only enough data to confirm the stage of development and to validate the mean length of utterance (MLU) (described in Chapter 7), but this is insufficient to adequately describe use patterns from which intervention goals can be determined. Occasionally, children fall into repetitive patterns of responding, such as naming pictures in a book. This kind of activity provides very little variation in a child’s behavior. It is best either to limit

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TABLE 5.7

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Guidelines for Language Sampling with CLD Children

Observe the child in various communication contexts, especially low-anxiety, natural communication environments. Observe the child with speakers of both languages or dialects. Language mixing during collecting may confuse the child. Record conversations with the child’s family for comparison. Explore with the family the child’s communication in the home and community environment. Use culturally relevant objects to stimulate conversation. Pictures should contain members of the child’s racial/ ethnic group. Avoid the tendency to “fill in” for the child’s communication gaps. Observe the child’s strategies for getting the message through. Note: Language uses and purposes. How flexible is the child’s system? Success at communicating. Are certain content and situations more successful? Communication breakdowns. Where do they occur? With whom? Strengths and weaknesses. What strategies are used to compensate for weakness? Anxiety and frustration. Source: Compiled from Battle (1993); Roseberry-McKibbin (1994); Stockman (1996).

this type of interaction or not to use it for analysis. If, on the other hand, a child frequently exhibits perseverative or stereotypic patterns, they should be recorded for analysis, saved for supporting data, or commented on in the assessment report. A language sample is recorded permanently by using an a log or digital recording, event transcription, or a combination of these (F. Roth & Spekman, 1984b). Samples can be recorded digitally on your MP3 player for listening or transferred to a computer for listening and transcription. Audio recording is essential because the interaction must be reviewed repeatedly for information. Although videorecording can be intrusive and expensive, especially the initial equipment purchase, it yields the best data for describing the verbal and nonverbal behaviors observed. You could even use your webcam if you have recording software. The alternatives to videotaping are not as reliable and thus increase the variability in the behavior recorded. Even if video is used, the SLP may find a simultaneous audio recording helpful for transcribing the speech and language portion. The following recording methods are listed in order of decreasing desirability: 1. Simultaneous video and audio recording. 2. Simultaneous audio with SLP descriptions of nonlinguistic behaviors recorded in one device and the linguistic interaction in the other. 3. Simultaneous audio recording and written-data recording on time sheets (see Table 5.8). Having more than one observer may help ensure that no behaviors are overlooked and may increase the reliability of description of those that are observed. Writing data as the interaction progresses is extremely tedious but necessary for some analysis. It is important for later transcription that different data collection methods begin at the same time. This should be accomplished as unobtrusively as possible. A cough or some similar signal by the SLP can alert observers that recording has begun but hopefully not alert the child being recorded.

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TABLE 5.8

Communication Assessment

Time Form for Recording the Nonlinguistic Context Minute 2

Time (sec.)

0 . . . . 10 . . . . 20 . . . . 30 . . . . 40 . . . . 50 . . . . 60

Child’s Behavior

Partner’s Behavior

Other

Looks at partner Points to truck

Reaches for truck Hands truck

Pushes car Looks at partner Points to gas station Moves car to gas station Moves car to gas station

Transcribing the Sample The conversational sample is transcribed as soon after recording as possible. This timeliness ensures that an SLP brings to the task as much memory of the situation as possible. The format of the transcript varies with the purpose of the assessment. For most purposes, the type of format shown in Table 5.9 is suggested. The use of computerized analysis programs, such as the Systematic Analysis of Language Transcripts (SALT), requires a consistent transcription format (J. Miller & Chapman, 2003) (see Appendix B). This format will include not only the utterances but also the symbols for the program to aid it in identifying morphological markers and syntactic categories. Usually, multiple analyses can be performed without reentering the transcript or with only minor changes to accommodate different transcription conventions and analytic capabilities (Long, 1991).

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Transcription Format Minute 2

Time (sec.)

0 . . . . 10 . . . . 20 . . . . 30 . . . . 40 . . . . 50 . . . . 60

Child’s Utterances

Partner’s Utterances

Nonlinguistic

What do you need now?

Can I have the truck?

C looks at partner C points to truck Which one?

That one Oh, the red one Okay Now can we go on vacation?

C reaches for truck P hands truck

Bro-o-om

C pushes car

We need gas first

C looks at partner C points to gas station Well then I’ll drive my car over, too

P moves car to gas station C moves car to gas station

What else do we need? Gotta get soda and chips

The SLP transcribes the linguistic behavior of both the child and the conversational partner, along with the nonlinguistic behaviors of each. The timesheet format in Table 5.9 enables the SLP to evaluate delays or latencies on the part of the child. All of the child’s utterances, including false starts, nonfluencies, and fillers, are transcribed. Although these linguistic elements may not be used for calculation of utterance length, they are extremely important in determining language and communication difficulties. All utterances of the conversational partner(s) also are transcribed. These are important in assessing the manner and style of the conversational partners. The SLP is interested in the amount of control and the amount and type of talking exhibited by the partner. Determining utterance boundaries is often difficult. This is not an exact science, and the artistry of an SLP is needed at this point. An utterance is a complete thought that is divided from other utterances by sentence boundaries, pauses, and/or a drop in the voice. Table 5.10 contains examples of utterance boundaries.

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TABLE 5.10

Communication Assessment

Utterance Boundaries

A sentence is an utterance. Mommy went to the doctor’s tomor . . . yesterday. Run-on sentences with and should contain no more than one and joining clauses. We went in a bus and we saw monkeys and we had a picnic and we petted the sheeps and one sheep sneezed on me and we had sodas and we came home. Utterances: 1. 2. 3. 4.

We went in a bus and we saw monkeys. (And) we had a picnic and we petted the sheeps. (And) one sheep sneezed on me and we had sodas. (And) we came home.

Other complex or compound sentences should be treated as one utterance. He was mad because his mommy spanked him because he broke the lamp and spilled the doggie’s water. Imperative sentences are utterances. Go home. Pauses, voice drops, and/or inhalations mark boundaries. Eat (pause and voice drop) . . . chocolate candy. Two utterances: Eat. Chocolate candy. Eat (momentary delay) . . . chocolate candy. One utterance: Eat chocolate candy. Situational and nonlinguistic cues help to determine boundaries. Eat (hands plate to partner insistently) . . . chocolate candy (points to candy dish). Two utterances: Eat. Chocolate candy. Want (reaches unsuccessfully) . . . mommy (turns to look). Two utterances: Want. Mommy. Want mommy (reaches unsuccessfully). One utterance: Want, mommy. The linguistic context also helps. Partner: Well, what do you want? Child: Candy (pause) . . . you get it. Two utterances: Candy. You get it.

Declaring sentences to be utterances is easy. Most of what is said, however, is not in complete sentence form. For example, the response to a question often omits shared information and might consist of such responses as “No,” “Cookie,” and “Okay.” Each of these is a complete utterance. Longer responses, such as “No, later” or “No, let’s go later,” are also single utterances. This determination might change if the child were to respond with a pause and a drop in the voice after “No.” “No (pause and drop voice). Let’s go later.” Now there are two utterances. Partial sentences or phrases, nonfluent units, and run-on sentences are even more difficult. A partial sentence might consist of the child pointing to an object and saying, “Doggie.” This would count

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as an utterance. Parts of sentences may be strung together, as in the following exchange in which the child makes an internal repair: Partner: I like to play mommy. Child: No, you not . . . me the . . . you baby. The entire unit is an utterance and will be analyzed in different ways by using all or part of what the child said. For run-on sentences, the SLP can follow the general rule that allows two clauses to be joined together in a sentence with and. In the following example, sentence/utterance boundaries have been marked as they might be on a transcript: [I went to the party, and we ate pizza] [(and) We played games, and I won a prize] [(and) We had cake and ice cream.] Division can be aided by the child’s pauses and breath patterns. Children in the late preschool years often make long strings of clauses with and meaning and then. Counting these as a single utterance inflates the mean utterance length. Young children are less likely to form run-ons with other conjunctions. Once the sample is transcribed, it can be analyzed.

Collecting Samples of Written Language With school-age children and adolescents, an SLP also will want to collect samples of their written language. Underlying language processes make it imperative that an SLP sample all modalities. Collection and analysis of written samples is explained in more detail in Chapter 13. If a teacher suspects that a child has a language impairment, he or she should contact the school’s SLP, who can ask the teacher to compile a portfolio of the child’s written work. It should include first drafts of both narrative and expository writing. In addition the SLP should elicit a written sample as he or she observes the child. In addition to the writing, the child’s general demeanor, the presence of frustration, the amount of help needed, and the look and quality of the finished product will be of interest. The child’s written language can be compared to the spoken sample for similarities and differences. Of particular interest will be language features noted in the language of older children, such as cohesive devices, noun and verb phrase structure, illocutionary functions, vocabulary and word relationships, conjoining and embedding, along with spelling and penmanship. These will all be discussed in later chapters.

Conclusion Collecting a representative language sample that demonstrates a child’s diverse abilities is a difficult task. Careful planning and execution are required, as are exacting methods of recording and transcription. Although these procedures may seem difficult and time-consuming initially, they can be accomplished

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easily and relatively quickly with practice. A properly planned and executed sampling and a thorough transcription will yield an abundance of linguistic and nonlinguistic information. Guides for collecting a language sample include the following: a positive relationship with the child before recording the language sample. • Establish Reduce your authority-figure persona to ensure more participation by the child. A child is more • likely to respond naturally with someone who is an equal. Be unobtrusive while collecting the sample so that the child is less conscious of the process. • The conversational partner should keep talking to a minimum. Although SLPs abhor a vacuum, • when possible you should wait out the child when possible. Avoid yes/no questions and constituent questions (e.g., what’s that?) that require only a one-word • response from the child. Ask process rather than product questions (e.g., how do you do that?) Follow the child’s lead in play and in the selection of topic. Determine the child’s interests before • beginning the collection process. Select those materials at the child’s interest level that are likely

• •

to stimulate interest. If the child does not talk or responds in a very repetitive or stereotypic manner, model responses for the child or have another person model. Collect more than one sample.

Only through sampling the child’s linguistic abilities in a conversational context can the SLP gain insight into how a child’s language works for that child. This is the first step in designing intervention that is relevant to the child and thus more likely to generalize to use environments.

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L

anguage is complex, and the analysis methods used with a conversational sample reflect this complexity. You were afraid I’d say that, right? For this reason, analysis of a language sample should not be a fishing expedition for possible problems. Language analysis is best used to explore certain aspects of a child’s behavior brought into question through other data collection methods. If a language disorder exists, it can be confirmed by descriptive analysis of a sample of the child’s unique language pattern. Traditional analysis has focused exclusively on the utterance or sentence as the unit of analysis. Although this type of analysis is appropriate for many language features, it may not be the best way to assess behaviors that transcend these units. To analyze language only at the utterance level is to miss many of a child’s language skills, especially those aspects that govern cohesion and conversational manipulation. Only by going beyond individual utterances can an SLP gain an understanding of a child’s use of the many language skills (Biber, 1986; Scott, 1987). For example, an analysis of a child’s use of pronouns necessitates crossing utterance boundaries in order to describe the child’s introduction of new information (. . . a doggie) and reference to old or established information (He . . .) that may have been introduced by the child or the conversational partner. In this chapter, we explore analysis across utterances and partners and by communication event, noting the adjustments a child must make to meet conversational demands. These analyses are suggested when an SLP suspects difficulties. Obviously, the many types of analysis mentioned in this chapter would be too numerous to examine and too time-consuming to perform with every child. Because little normative information is available on conversational skills, analysis at these levels is largely descriptive. Table 6.1 presents some types of analyses possible across utterances and partners and by communication event.

TABLE 6.1

Types of Analysis Beyond the Utterance

Across Utterances and Partners

By Communication Event

Stylistic Variations Register Interlanguage and Code Switching Channel Availability Referential Communication Presuppositional Skills: What Is Coded and How Linguistic Devices: Deictics, Definite and Indefinite Reference Cohesive Devices Reference: Initial and Following Mention Ellipsis Conjunction Adverbial Conjuncts and Disjuncts Contrastive Stress

Social Versus Nonsocial Conversational Initiation: Method, Frequency, and Success Rate Topic Initiation: Method, Frequency, Success Rate, and Appropriateness Conversation and Topic Maintenance: Frequency and Latency of Contingency Duration of Topic: Number of Turns, Informativeness, and Sequencing Topic Analysis Format: Topic Initiation; Type of Topic; Manner of Initiation, Subject Matter, and Orientations; Outcome; Topic Maintenance: Type of Turn; and Conversational Information Turn Taking: Density, Latency, and Duration Overlap: Type, Frequency, and Duration Signals Conversation and Topic Termination Conversational Breakdown Request for Repair: Frequency and Form Conversational Repair Spontaneous Versus Listener-Initiated Strategy and Success Rate

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It is important for an SLP to remember that many of the language features discussed in this chapter are dependent on the behavior of a child’s partner and vary with the situation and the culture of the child and the conversational partner (Crago & Eriks-Brophy, 1992). The stimuli and reinforcers and the child’s response to each, the conversational roles of each partner, and the type and amount of communication are contingent on cultural values. Tasks should be culturally relevant with functional, meaningful, culturally appropriate language. Sampling results should be analyzed with cultural variability in mind. For example, the cultural norm may be that adults do not respond quickly to children.

Across Utterances and Partners Analysis at the utterance level reveals much about a child’s discrete, finite language skills but may obscure a child’s knowledge of the “big picture,” the cohesion that threads through conversations. Some linguistic devices serve this cohesive purpose, and larger units than the utterance must be analyzed to assess their development. Other devices vary across whole conversations, and one sample may be very different from another. STYLISTIC VAR IATIONS The style of talking, whether formal, casual, or varied in other ways for the situation, usually does not change utterance by utterance. Rather, it is a manner of talking with a specific language partner or in a specific situation. Different styles also may be seen in role-play. An SLP may be interested in the different styles used by a child in the various samples collected. As early as age 4, children use a different style of talking when they address younger children learning language. This style resembles motherese or parentese, the stylistic changes made by parents when they address these same younger children. Mature language users have a variety of styles at their disposal and can switch styles with little effort. Such variation requires a speaker to consider the listener and the situation and the resultant requirements on the speaker. Register Style switching, the move from one style or register to another, must be judged against the age, gender, and language ability of the speaker and the listener. Styles differ according to role-taking characteristics, dialectal variations, amount of politeness, and conversational control. Conversational roles can be established by the topics chosen, vocabulary (dear, sir, honey), pronunciation, and the discourse style (formal, casual, playful, etc.) selected. Usually, the more dominant partner takes longer turns and asks more questions. The degree of politeness also varies. In general, speakers are more polite when in the less dominant role or when requesting something that belongs to or is controlled by the other partner, who may be unlikely to grant the request. Children with LD often fail to use registers based on differing situational variables. Data suggest that these children do not adjust to different speakers or may adjust in different ways from children developing typically. Children with LD may fail to recognize the characteristics of different settings. The child with LI may not be able to discriminate dominant from nondominant roles and the language form that goes with each. The most frequent problems with register include providing insufficient information for the listener, not knowing when to make a statement, asking inappropriate questions, giving insufficient reason for the cause and effect of a situation, and not adjusting register to the speaker

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(A. Johnson, Johnston, & Weinrich, 1984). It may be especially difficult for a child with LD to express feelings and emotions. These expressions may be very direct. An SLP studies the sample to determine the stylistic variations present. The value of collecting language samples in two very different but client-appropriate situations is apparent. The SLP should look for modifications in politeness, intimacy, and linguistic code based on the age, status, familiarity, cognitive level, linguistic level, and shared past experience of the listener (F. Roth & Spekman, 1984a). Of interest is the attention the child gives to the listener’s characteristics. In addition to noting stylistic variations, the SLP looks for inappropriate styles—those that are too formal, too casual, or include excessive swearing, for example. The SLP might note features such as differing utterance length with various partners. Other variations include vocabulary and topic. More subjective indices include intonational patterns and the use of attention-getting and maintaining devices. Interlanguage and Code Switching With children with LEP, it is important to establish patterns of language use in both L1 and L2 (Hamayan & Damico, 1991). Two possible patterns are called interlanguage and code switching. Interlanguage is a combination of the L1 and L2 rules, plus ad hoc rules from neither or both languages. This “hybrid” language varies among children and within an individual child across situations (Tarone, 1988). Usually, interlanguages are transitional in nature, but some features may stabilize as a permanent form, especially if there is little motivation to change. Predictable patterns should be identified during observation and sampling. Of interest are the rules used by the child and any situational variables. Linguistic code switching is the shifting from one language to another within and/or across different utterances. A complicated, rule-governed behavior, code switching does not signal poor language skills, although it may be used by children when they have inadequate L2 skills. As with interlanguage, code switching is influenced heavily by contextual and situational variables (Sprott & Kemper, 1987). For example, the Spanish-speaking storyteller might use English when referring to Anglos and Spanish when referring to Latinos. Code switching follows agreed-upon community rules and usually occurs to enhance meaning, emphasize a change of topic, and convey humor, ethnic solidarity, and attitudes toward the listener (Hamayan & Damico, 1991). The SLP should note uses of interlanguage and code switching, along with sampling variables such as the situation and the partner(s). It is especially important to identify patterns that may impede the transmission of meaning or interrupt communication. Channel Availability Most children below age 11 experience less communication success when they do not visually share the communication environment with their listener, as when on the phone (F. Roth & Spekman, 1984a). As the number of communication channels decreases, a child with LI should have increasing difficulty communicating. In fact, children with LD often have great difficulty if forced to rely solely on the verbal channel. The SLP should note in the sample the relative success of the child’s communication efforts as the number of channels varies. R E FE R E NTIAL COM M U N ICATION Referential communication is the ability of a speaker to select and verbally identify the attributes of an entity in such a way that the listener can identify the entity accurately (Bowman, 1984). To succeed, the speaker must be able to determine what information the listener needs, deliver that information

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in a specific manner, make comparisons, and use feedback on message adequacy and breakdown. While “He has brown hair” fails to communicate the referent, “The only boy in my history class has brown hair” succeeds. Referential communication includes directions, explanations, and descriptions. These are three essential aspects of classroom discourse, and their impairment may contribute to the academic difficulties of children with LD (Donahue, 1985). Presuppositional Skills Presupposition is a speaker’s assumptions about the context and about the listener’s knowledge that modify the manner and content of the speaker’s utterances (A. Johnson et al., 1984). The speaker must take the conversational perspective of the listener(s) and determine what information to communicate and its form. From early on, informativeness is a characteristic of communication. Even toddlers tend to code information that is maximally informative, thus talking about things that are new, different, and changing. For most children, the receptive and expressive ability to consider a partner’s perspective is well established by age 10. Although both comprehension and production require understanding of the critical features needed, production also requires knowing how and when to provide information. Children with LD have poor referential skills and are less likely to adjust to the listener and more likely to provide ambiguous and insufficient information. In addition, although children with LD seem to understand directions given by others, they take longer to comply than do age-matched children who are non-LD (Feagans & Short, 1986) and have great difficulty giving adequate instructions. An SLP should be alert to the informativeness of a child’s utterances and to the social context. The following questions can be applied to the sample (F. Roth & Spekman, 1984a): does the child choose to encode in the situation? • What Does the child encode what is novel or merely comment on what is already given? • Does the child encode new information gesturally or linguistically? • Are messages informative, vague, or ambiguous? • Are different referents clearly • Does the child talk differentlyestablished? about things present and things not? • What Is Coded and How Conversations usually contain information that is novel and informative. The SLP is interested in whether the child adds to the conversation or only comments on what is given. In the following exchange, the child takes a turn but adds nothing of substance to the conversation. Partner: Wasn’t that a great baseball game on TV last night? Child: Yeah, great game. Partner: What a great home run in the top of the ninth; I didn’t expect Cincinnati to pull it out. Child: Great home run. Partner: I think they’ll probably go on for the pennant. How about you? Child: Pennant. If this sounds like the conversation of someone who doesn’t know the topic well enough to comment, that may be partially correct. The child may not be able to identify the topic. Frequent repetition may indicate a semantic (word retrieval), processing, or pragmatic (not sure of the contextual demands) problem.

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TABLE 6.2

Types of Noninformative Language

Empty phrases (common idioms, such as and so on and et cetera, excetera) Indefinite terms and highly nonspecific nouns (one, thing, that) Deictic terms (this, that, here, there) Pronouns used without antecedent nouns Comments on task instead of stimulus Neologisms (Oh, you know the one that you fly in) Paraphrases Repeated words or phrases Personal value judgments about the stimulus (That’s pretty dumb) Use of and alone Conjunctions but, so, or, and because alone Source: Adapted from Nicholas, Obler, Albert, & Helm-Estabrooks (1985).

Noninformative language can take several forms (Nicholas, Obler, Albert, & Helm-Estabrooks, 1985). Table 6.2 presents forms and examples seen in children with LI. These types of noninformative language may be especially useful when rating the language of children with TBI and LD. The SLP can rate utterances to determine the strategy used by the child. Linguistic Devices Several linguistic devices are used to mark informativeness, including deictics and direct/indirect reference (F. Roth & Spekman, 1984a). Both of these devices can be used to note referents internal or external to the conversation; other cohesive devices, listed in Table 6.3, establish relations entirely within the discourse. Deictics As mentioned in Chapter 5, deictic terms are linguistic elements that must be interpreted from the perspective of the speaker in order to be understood as the speaker intended. The use of deixis is TABLE 6.3

Cohesive Devices Used in English

Relation

Explanation

Example

Reference

Initially, the entity is named and may use the indefinite article (a/an). Subsequent mention may use a pronoun, words such as this, that, and one, or use the definite article (the) with the noun.

John went looking for a car. He found one in the city. I want to buy a coat, but that one I saw last night is too expensive.

Subsequent sentences omit redundant or shared information.

Who ate all the cookies? I did [eat all the cookies].

Ellipsis

I would like to make a phone call. May I [make a phone call]? Conjunction

Conjunctions join clauses to express additive, causal, and other relationships.

Source: Adapted from Halliday & Hasan (1976).

We went to the circus, and I saw elephants. John’s angry because I drank his soda.

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based on the speaker principle, in which the referential point shifts as speakers change, and on the distance principle, in which referents are coded by their distance from the speaker. Words with deictic meanings appear in several word classes, including personal pronouns (I/me and you), demonstrative adjectives (this, that, these, and those), adverbs of time (before, after, now, and then), adverbs of location (here and there), and verbs (come and go). A child’s behavior, especially the errors, should be analyzed to determine confusion or overreliance on one principle or one aspect of a principle. Definite and Indefinite Reference A mature language user is able to mark specific (definite) and nonspecific (indefinite) referents by manipulation of definite (the) and indefinite (a/an) articles. The speaker must consider what the listener knows about the topic under discussion. Article use can be especially difficult for a child with LI. In part, this difficulty may reflect the use of articles in English to mark new and old information also. The tendency for children with LI is to overuse the definite article the. Each article present in the sample can be analyzed for appropriate referential use. Note that Asian American LEP speakers may omit articles reflecting nonuse in many Asian languages. COH ESIVE DEVICES Conversational cohesion, how language hangs together, can be a useful analysis tool. Cohesion can be expressed through syntax and vocabulary. For example, a pronoun or a demonstrative, such as this or that, can refer to the referent, which was identified previously in the conversation. Conjoining, the connection of phrases, clauses, and sentences through the use of such conjunctions as and, because, and if, also is used for cohesion. The major cohesive devices used in English are listed in Table 6.3. The most frequent problems of cohesion relate to providing redundant information, deleting necessary information, using unclear and ambiguous reference, sequencing old and new information, and marking old and new information with articles and pronouns. In short, errors usually reflect including or excluding too much information or confusing new and old information. Reference Reference is a linguistic device used continuously in conversation to keep information flowing and to designate new and old information. In the process, new information is stated clearly and then subsequently implied by the referral to it as old information, one utterance presupposing the other. I’ll explain all this in the following section. Some children with language impairments, such as children with ASD, have difficulty marking new and old information (McCaleb & Prizant, 1985). An SLP must note the method of introducing new information and the use of following mention. Speakers should ensure that listeners can easily determine noun-pronoun relationships. This investigation requires looking beyond traditional utterance-level analysis. Initial Mention In initial mention, mature speakers establish mutual reference clearly, especially if the entity mentioned is not present. Generally, the referent name is stressed and preceded by the indefinite article (a/an). In English, the referent often is placed at the end of the sentence, the most salient position. The following are examples of the introduction of new information: Did you see John at the party? We went to a circus yesterday.

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In addition, referents that are present may be pointed to or handled. Young children tend to rely more on these nonlinguistic behaviors to establish new referents. Children with LD or ASD have difficulty with new information (McCaleb & Prizant, 1985; Rees & Wollner, 1981). As speakers, they may not identify new information for the listener, assuming that the listener “just knows” what they’re is thinking. As listeners, these children may have difficulty identifying the new information but will ask few questions to clarify. “These children often do not know what they do not know” and thus cannot inquire about it (Stark, 1985). With increasing language skills, the child is able to be more specific linguistically. Children with word-finding difficulties or poor vocabularies may use empty words, such as that, one, or thing, that do not help clarify the referent. These children may rely on the immediate context and use pointing to specify the referent that their nonspecific vocabulary failed to identify. Following Mention In following mention, previously identified referents often are moved to the initial position in English sentences and may be referred to by the use of the definite article (the) or a pronoun. “Did you see John at the party?” might be followed by “He was so thrilled.” This referral to previously cited information is called anaphoric reference. Pronoun use is appropriate when the referent is unambiguous or clearly identified. The pronoun should be in close proximity so that there is no confusion as to which noun it refers. An SLP is interested in the way a child introduces new information and refers to that information later. Also of interest is any confusion with article and pronoun use. Pronouns and a method of recording a child’s use are included in Table 7.14. It is not uncommon for a preschool child or a child with LD to introduce new information with “She did it,” leaving the listener to determine who she is and what it is. Ellipsis Ellipsis is a process in which redundant information is omitted. For example, the response to “What do you want?” is “Cookie,” which omits the shared information “I want.” Elliptical fragments are used frequently to keep the conversation moving smoothly and rapidly, but they are missed if linguistic analysis concentrates solely on full sentences or fails to look across partners. Children with LI may not realize that information is shared or may assume that it is shared when it is not. Either assumption interferes with the flow of conversation. For example, the child might repeat, “Cookies, Cookies, cookies,” until someone asks, “What about cookies?” to which the child responds in surprise,“I want some,” having assumed previously that the I want was shared when in fact there was no “what do you want?” asked. Conjunction Conjunctions, such as and, then, so, and therefore, are used to connect thoughts. Although preschool children have several conjunction-type words in their vocabularies, they rarely use them to join clauses. Even kindergarten children will overrely on and, which becomes an all-purpose conjunction. In addition, and often is used to mean and then when giving a sequence of events. A developmental progression for conjunctions is given in Table 7.16. Just as conjunctions can be analyzed at the utterance level because of their use in linking clauses, conjunctions can be analyzed across utterances, as in the following exchange.

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Parent: We had a great day at the zoo. I liked the monkeys best. Child: And feeding the deer babies. Analysis at the level of the child’s utterance alone would miss the child’s considerable skill. Adverbial Conjuncts and Disjuncts Adverbial conjuncts and disjuncts are conversational devices used for cohesion. Conjuncts are intersentential forms that express a logical relationship, such as the conjunctions then or so. Conjuncts are of two types: concordant, such as similarly, consequently, and moreover, and discordant, such as nevertheless, rather, and in contrast. Disjuncts are used to comment on or to convey the speaker’s attitude toward the topic and include words and phrases such as honestly, frankly, perhaps, however, yet, to my surprise, it’s obvious to me that, and the like. Conjuncts and disjuncts develop rather late in childhood and, therefore, may be good measures of adolescent language. Growth is “slow and protracted” (Nippold, Schwarz, & Undlin, 1992, p. 108). By age 12, children use only an average of 4 conjuncts per 100 utterances (Scott, 1988a). In contrast, adults average 12 conjuncts per 100 utterances. Children between ages 6 and 12 use conjuncts infrequently and rely most frequently on then, so, and though (Scott, 1984a). Adolescents use the same conjuncts but also use therefore, however, rather, and consequently most accurately in both their reading and writing (Nippold, Schwarz, & Undlin, 1992). Comprehension seems to be better than production although similar (Nippold, Schwarz, & Undlin, 1992; Scott & Rush, 1985). The conjunct then can be used to signal both continuity and discontinuity in adolescent and adult language (Segal, Duchan, & Scott, 1991). Initially, children use then to mean next, joining clausal information. Later, then is used to focus on ideas presented previously, in contrast to now, which signals that new ideas will be presented on some topic. In addition, then can signal discordance, as in “Then again, I believe . . .” In mature narratives, then is used approximately 20 percent of the time to mark discontinuity by indicating a shift (Duchan & Waltzman, 1992). This shift might be to (1) a different discourse type, as in conversation to narration or the reverse, (2) a new scene or location, (3) a different character in a narrative, or (4) a new perspective. Use of then seems dependent on the use of other conjuncts, such as anyway, meanwhile, whatever, and now. Narratives, discussed in Chapter 8, offer insight into conjunct use. Contrastive Stress Contrastive stress or emphasis can be used to negate or correct the message of a conversational partner. For example, if one speaker said,“Jose brought the cookies,” the other might correct,“Mary brought the cookies.” Again, an SLP must transcend the traditional utterance-level analysis.

Communication Event The term communication event can represent an entire conversation or a portion thereof that includes one topic. For purposes of our discussion, we use the larger definition and include within it a conversation that comprises one or more topics.

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Usually, a shared or negotiated agenda(s) occurs within a conversation. Utterances within the event support this agenda. The teenager who wants to be granted a privilege, such as getting to use the family car, is polite, and each utterance supports this agenda. Conversations may be very difficult for some children unfamiliar with the process or unable to decipher the code. A child may be unclear about the purpose of conversation and his or her role in it. Much of this difficulty can be alleviated by using familiar conversational partners and situations and by following a child’s lead. Younger children and those with LI may need events with more definite beginnings and ends, such as putting together a puzzle. The social organization of discourse consists of the two roles of speaker and listener. The effective communicator has the ability to function in and contribute to the conversation by assuming responsibility for both roles. Assessment variables that might measure a child’s ability to participate effectively are the amount of socialized speech and a child’s adaptive style; conversation and topic initiation, maintenance, and termination; the completeness, relevance, and clarity of a child’s behavior; on-topic exchanges and turn taking; and conversational repairs (James, 1989; Lund & Duchan, 1993; Prutting, 1983; F. Roth & Spekman, 1984a). Analysis occurs at two levels: the molar and the molecular (Prutting, 1983). At the molar level, an SLP evaluates each behavior for appropriateness or inappropriateness within the conversational context. Inappropriate behaviors may indicate problem areas for further assessment. At the molecular level, an SLP is interested in the frequency, latency, duration, density, and sequence of the child’s behaviors. Frequency data will reveal inordinately high- or low-frequency features and information on the range of features. Latency, the span of time when an individual does not engage in behavior, is also important. Pauses and hesitations may reveal difficulty decoding the preceding utterance or forming a response. Duration is the length of time that a child and a partner are engaged in a certain behavior, such as conversational gaze or conversational turns by both partners. Density is the number of behaviors within a certain period of time. Of interest are the density of different conversational topics or specific linguistic structures, such as questions. Sequence includes the order of events within a topic or conversation. A child exhibiting difficulty with sequencing of a conversation may not understand the rules of conversational participation. Decisions of appropriateness may be facilitated through the use of a modified ethnographic technique similar to that used in anthropological studies. Using an expository form of writing, an SLP attempts to describe each child utterance with reference to form, content, and use, discourse relations, code switching, learning and cognitive style, and the partner’s arrangement and selection of nonlinguistic strategies, materials, and procedures (Constable, 1992). Thus, each utterance is given a reference frame in which to judge appropriateness. Table 6.4 provides a sample of a dialogue and the accompanying ethnographic analysis. Ethnographic techniques are especially important when assessing children with CLD backgrounds (Roseberry-McKibbin, 1994). SOCIAL VE R SUS NONSOCIAL Social speech is speech addressed explicitly to and adapted for a listener. It is characterized by explicitness and clarity, repairs of breakdowns, and an obligation for a listener to respond. Social communication includes dialogues and social monologues addressed to a listener or uttered for the mutual enjoyment of both the speaker and listener, such as rhyming and poetic nonsense. The speaker adapts the explicitness of the message for the listener and repairs breakdowns. The speaker’s message is delivered as if the speaker expects a listener response.

Chapter 6

TABLE 6.4

Analysis Across Utterances and Partners and by Communication Event

155

An Example of Ethnographic Analysis

Language Sample

Ethnographic Analysis

Child: What’s that?

Child does not seem to know the identity of an object and inquires as to its name with an appropriate wh- question addressed to the partner. The partner supplies an appropriate answer but does not elaborate. The child seeks such elaboration by asking a second wh- question in which he omits the auxiliary verb. Other sentence elements are included in the proper adult word order. The partner does not answer the question but responds with a second whquestion in order to have the child guess at the function from its appearance. The child responds inappropriately to the partner’s question, either ignoring the content of the question or miscomprehending the meaning of the wh- word. The partner does not pursue the question by restating or reformulating it. Instead, the partner confirms the child’s utterance and asks a third whquestion incorporating the child’s utterance. Again, the child does not respond to the content of the partner’s question but repeats the previous utterance with no additional information to aid the partner’s understanding.

Partner: That’s a “Thing-a-majibit.” Child: What it do?

Partner: What do you think it does? Child: On the table.

Partner: YES, on the table. What about “On the table?” Child: On the table.

In contrast, nonsocial speech is not addressed explicitly to a listener, and the listener has no obligation to respond. Nonsocial communication is usually for the speaker’s own enjoyment and often consists of asocial monologues. An important measure of communication is the percentage of the child’s utterances or the amount of total talk time that can be characterized as social (F. Roth & Spekman, 1984a). Although preschoolers produce many asocial monologues accompanying their play, the amount of time spent in this type of production decreases with age. School-age children developing typically produce very little nonsocial speech. In general, children’s communication becomes more interpersonal as they mature, with girls more likely to use language cooperatively (D. Cooper & Anderson-Inman, 1988). Boys are more likely to show domination and control, to interrupt and insult, and to play practical jokes. Older adolescents are more concerned for the wants and feelings of others, compromise and reach mutual agreement more, and are more concerned for long-term consequences in their communication than are younger adolescents or children (Selman, Beardslee, Schultz, Krupa, & Podorefsky, 1986). CONVE R SATIONAL I N ITIATION The most efficient way to initiate a conversation is to gain your listener’s attention, greet the listener, and clearly state the topic of conversation or some opener, such as, “Guess what happened to me yesterday?” or “Where have you been? I haven’t seen you in ages.” Openers set the tone of the conversation and the subsequent turns. Opening and closing a conversation is one of the pragmatic problems most frequently encountered in children with LI (A. Johnson et al., 1984). Children with ASD initiate very little conversational behavior—even less than do other children with LI (Loveland, Landry, Hughes,

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Hall, & McEvoy, 1988). Of clinical interest is how a child initiates the conversation and how successful he or she is in having the conversation continue (F. Roth & Spekman, 1984a). Method It is best to get a potential listener’s attention before initiating a conversation. This usually is accomplished by eye contact and a greeting. A child with LI may begin without any greeting or may interrupt an ongoing conversation with, “Hey.” While in a classroom recently, I become aware that a preschooler was talking to my butt. He had neither sought my attention nor offered a greeting. Some children use the same opener repeatedly (e.g.,“Guess what?”), whatever the conversational context. Data may need to be collected over a wide variety of situations to discern a pattern. Role-play or play with puppets or dolls can be used to determine a child’s knowledge of conventional openers. Frequency and Success Rate Children who are withdrawn or unsure of the conversational expectations may initiate conversations only rarely. Instead, they adopt a more passive, responsive role. In contrast, other children may interrupt frequently and attempt to initiate conversation indiscriminately. Of interest to an SLP is the density of initiations, or the number of initiations over a given time. Obviously, this figure will change with the situation. For children, lunchtime, recess, and group projects may be appropriate forums in which to collect such data. The success rate of children in initiating conversations is also significant. Although children may attempt to begin conversations frequently, they may be ignored or mocked, depending on the audiences they choose. Each of us has experienced the “cold shoulder” at least once. Children who are socially inappropriate may experience more than their share. An SLP should note the manner of initiation. TOPIC I N ITIATION Once a conversation has been initiated, the participants negotiate the topics that will be discussed. Topic can be defined as “the proposition or set of propositions or subject matter about which the speaker is either providing or requesting new information” (Bedrosian, 1988, p. 270). This negotiation process begins with one partner introducing a topic; the other partner agrees to adopt that topic by commenting on it, disagrees by changing the topic, or ends the conversation. Mature speakers identify the topic clearly by name and, if in the immediate context, by pointing. Preschool children and those with LI rely more on nonlinguistic cues, such as pointing to and holding or shaking objects. In general, children with LI are less adept than both their age-matched and language-age-matched peers in their ability to direct the conversation by introducing topics (Donahue, 1983). This lack of ability might reflect difficulty introducing topics clearly and/or these children’s limited lists of potential topics (Bedrosian, 1985; Dollaghan & Miller, 1986). Method An effectively initiated topic is identified clearly in order to establish mutual regard. As mentioned, a speaker may point, look at, and/or state the topic. Generally, the speaker provides information the listener needs to identify referents and their relationships. Topics are negotiated between speakers, and even when explicitly stated, topics are based on the shared assumptions of each participant.

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In general, the less sure a speaker is that a listener knows the topic, the longer the speaker will take to introduce it. A more mature speaker is adept at presupposing the prior knowledge of the listeners. In return for the introduction, listeners assure speakers that they understand, or they ask for clarification when they do not understand. Topics typically are changed by stating a new one. Older elementary school children, adolescents, and adults increasingly use a conversational technique called shading, in which the conversation is steered from one topic to a closely related one. Adult conversations only occasionally contain very disparate topics. Although we don’t possess much normative data, we know that between seventh and twelfth grade the number of abrupt topic shifts in an adolescent conversation decreases from 3.19 to 1.44 (Larson & McKinley, 1998). A child with LI may not establish topics, preferring to adopt those of others. If a child does introduce topics, there may be little or no background information to aid the listener (Brinton & Fujiki, 1992). A child with LI may have a very restricted set of conversational or topic openers or may rely on a stereotypic utterance (e.g., “Guess what?”). Children with emotional difficulties may continue some internal conversation with the assumption that the listener has been privy to this information. As mentioned previously, children with word-finding difficulties or poor vocabularies may rely on nonspecific nouns, such as one or thing. Nonspecific verbs, such as do and get, also may be used frequently. “I did that one” may not get the topic off to a roaring start. A child’s responses to the openers of others may be nonexistent or noncontingent/off-topic. The child may not be able to identify the topic or to determine what response is required to the partner’s opener. Both the linguistic and nonlinguistic aspects of a sample should be analyzed. The nonlinguistic aspects, such as eye contact, regulate the linguistic ones and are significant in the regulation of turn initiation and termination, topic choice, and interruptions (Prutting, 1982). Frequency and Success Rate As with conversational initiation, the density and success rate of topic initiation are noteworthy. In general, less dominant speakers will introduce fewer topics and will be less successful in having their topics adopted by their partners. Lack of success also may indicate problems with topicalization, such as establishing and commenting on, marking changes in, and maintaining the topic for a sufficient length of time (A. Johnson et al., 1984). Related factors to be evaluated are the articulation clarity, degree of completeness, and form of the topic statement; social adaptation of a child’s language style; degree of content relevance to the ongoing activity and to listener interests; use of eye contact; and physical proximity (F. Roth & Spekman, 1984a). Appropriateness The appropriateness of a topic is determined by the context. Some topics, such as the weather, are always appropriate, whereas others, such as age, income, or sexual behavior, are appropriate only in limited contexts. Each of us has favorite topics. An SLP is interested in determining a child’s favorite topics and in assessing their appropriateness in context. Although some topics will work in one context, they are inappropriate for others. Some children with LI have only limited topics or perseverate on a few regardless of the context. I worked with two brothers with ASD who seemingly could talk only about mathematics. A third child with severe LD seemed limited to discussing throwing up, a topic with not much appeal.

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CONVE R SATION AN D TOPIC MAI NTE NANCE Once a topic is introduced, speakers comment, each sentence reflecting the general discourse topic. In effective conversations, the participants seem to adhere to four principles: stay on topic, be truthful, be brief, and be relevant (F. Roth & Spekman, 1984a). Each partner depends on a response’s contingency, or relatedness to the preceding utterance. Each response adds new information on the topic. The topic is mentioned frequently enough to enable both participants to recall it as the conversation progresses, because the topic becomes less specific with each subsequent reference. Topic continuance may be signaled by maintenance devices, such as now, well, and then, in any case, next, so, followed by I (you, we, they) (did something). Some devices, called continuants, maintain the conversation but add little if any new information. Examples of this behavior are yeah, uh-huh, and okay when used as a signal that the listener is paying attention. Other maintenance devices are repeating a portion or all of the previous utterance. Children with LI tend to engage in fewer and shorter interactions than do children developing typically. The most frequent pragmatic problems for children with LI include connecting discourse cohesively, listening and responding to a speaker, knowing when to take a turn, and knowing how to ask and answer questions (A. Johnson et al., 1984). Although there is little difference between the turn-taking skills at the one-word level of children with LI and of those without, a disparity occurs and widens as language becomes increasingly more complex (Foster, 1985; Prelock, Messick, Schwartz, & Terrell, 1981; Reichle, Busch, & Doyle, 1986). Children with ASD may not respond to initiations, while other children with LI may overuse turn-fillers or acknowledgments (uh-huh) to keep the conversation going even when their comprehension is lacking. (Bedrosian, 1988; Brinton & Fujiki, 1989). Frequency of Contingency Semantically contingent utterances relate to or reflect the meaning of the prior utterance. Thus, a contingent utterance maintains the topic of the previous utterance and adds to it in some way. For example, in response to the utterance, “We went to Captain Jake’s for dinner last night,” a second speaker might make the contingent remark “Oh, did you enjoy the food?” A noncontingent remark would be “My uncle lives on a farm.” Assume for a moment that the name of the restaurant in the previous example was Uncle Jake’s. In this situation, the child’s remark,“My uncle lives on a farm,” although off-topic, does have some link to the previous sentence. If these links can be identified, there may be a pattern that will reveal the child’s processing strategy. In general, children with LI are less responsive than are their age-matched TD peers (RosinskiMcClendon & Newhoff, 1987). This low level of responsiveness may reflect a history of unsuccessful communication. Often, these children respond to questions with stereotypic acknowledgments (uh-huh, yeh) and with nonspecific requests for clarification (what, huh) (Rosinski-McClendon & Newhoff, 1987). The frequency of contingent behaviors by a child and caregiver also is of interest. The child who exhibits few contingent utterances may prefer to initiate new topics instead. The SLP notes the percentage of a child’s utterances that are on-topic, the relevance of the child’s questions, and the child’s nonverbal responses, such as following directions or looking at something that was mentioned. A large percentage of off-topic responses may indicate a semantic disorder characterized by difficulty in identifying the topic of discussion. A listener’s ability to identify a topic subsequently affects

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comprehension of comments made about that topic. Imagine responding to “what do you think?” When you can’t identify what’s being discussed. The SLP should look for an underlying contingency that may not be readily obvious. Children with LD may assume that their partners know the underlying relationship and, therefore, may only include unshared information. Of particular interest are the child’s responses to questions. Such responses should be appropriate to the question and factually correct. For example, the question “Why is he eating?” might elicit the following responses from different children: 1. 2. 3. 4. 5.

Food. Because. He has to. So he won’t be hungry. He’s hungry.

The first answer is inappropriate although functionally accurate. It does not answer the question, but tells what the man is eating. The second and third responses are appropriate but too brief to be accurate. The fourth and fifth answers fulfill appropriateness and accuracy criteria. If an answer does not fulfill both appropriateness and accuracy requirements, it is in error and may indicate any number of possible breakdowns in the communication process. I have worked with a child with severe emotional disorder who gave extremely inappropriate replies to emotional or personal questions, although her responses to factual questions were usually both appropriate and accurate. A child with LI may not understand what the questioner desires or may not realize that a reply is required. The question form and the specific wh- question type also may be confusing. In general, recognition and delivery of the general kind of information required develops prior to the ability to respond with the accurate information. Some wh- question forms seem easier than others. Three groupings, from easiest to most difficult, are as follows: Easiest Most difficult

What + be, which, where Who, whose, what + do When, why, what happened, how

This order suggests a hierarchy for both analysis and intervention. In addition, it is easier for children to respond to questions referring to objects, persons, or events within the immediate setting. Various semantic question prompts can be used to facilitate production of a child’s inadequate responses. A child’s responses to these prompts can provide useful information for intervention, such as knowing which prompts aid responding. Table 6.5 presents a procedure for comparing the efficacy of various prompts in eliciting appropriate and accurate responses from a child. A plus sign (+) indicates appropriate or accurate responses; a minus sign (–) indicates inappropriate or inaccurate ones. Latency of Contingency When a child makes a contingent response, there should be little delay or latency between his or her turn and the preceding speaker’s turn. Gaps between the turns of mature speakers are brief or nonexistent. Research has indicated that the average amount of time needed for two adults to switch from

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Score Form for the Efficacy of Various Question Prompts Prompt Effectiveness (+, –)

Prompt Type

Strategy Description

Standard focusing phrase with repetition

Listen to the question signals the student that a response was in error. Direct student’s attention to the repetition; highlight content.

Model example with related content

Use another adult or child in context to model correct response. Then ask child, same form, new content.

Analogous examples

What are alligators covered with? —No response. Seals are covered with fur. What are alligators covered with?

Visualization of relationships

How are an apple and a cook alike? No response. Draw semantic feature chart: grows bakes eat on tree

Relevant comparison yes/no

Appropriate

apple

+

+

+

cookie

+

+

–

Accurate

Comments

What does a hockey player need? No response. Does a hockey player need skates? Yes. Good. What does he need?

Note: The child’s inadequate responses can be modified by using question prompts. Successful responses following a prompt are recorded as a + under both the appropriate and accurate columns. Source: Moeller, M., Osberger, M., & Eccarius, M. (1986). Cognitively based strategies for use with hearing-impaired students with comprehension deficits. Topics in Language Disorders, 6 (4), 37–50. Reprinted with permission.

one speaker to the next is half a second or less. Although there are no norms for children, this value is an important description measure. Preschoolers and children with LI may allow long gaps to develop without any of the apparent embarrassment found among adults when there are long unfilled pauses. A noticeable latency prior to a child’s response may indicate word-finding difficulties or lack of comprehension. Frequently, the linguistically more mature partner will fill in for the child, an act that violates the rules of turn taking. Latency is an important measure for both contingent and noncontingent utterances, whether adjacent or nonadjacent. Adjacent utterances are spoken as sequential behaviors by the same speaker. A nonadjacent utterance crosses conversational turns and is an utterance or turn of one partner followed by an utterance or turn of the other. Definitions and examples of these categories are presented in Table 6.6.

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Definitions and Examples of Utterance Pairs

Types

Definitions

Examples

Contingent

The utterance of one speaker is based on the content, form, and/or intent of the other speaker.

S1: What do you want for lunch? S2: Peanut butter. S1: I hope I don’t miss my plane. S2: Don’t worry. Every flight is delayed.

Noncontingent

The utterance of one speaker is not based on that of the other.

S1: What do you want for lunch? S2: Gran’ma gots a new car.

Adjacent

Utterances spoken sequentially by the same speaker.

We went to the zoo. I saw monkeys and elephants. But my favorite part was petting the sheeps.

Nonadjacent

Utterances spoken sequentially by different speakers. The utterances may be contingent or noncontingent.

S1: Here comes the school bus. S2: Yukk, I was hoping he’d get a flat tire. (Contingent)

DU RATION OF TOPIC A topic is sustained as long as each conversational partner cares to continue and can contribute relevant information. The number of turns taken on a topic is a function of the particular topic and partners involved, the conversational context, and the conversational skill of each participant. Number of Turns on a Topic The SLP is interested in the number of turns taken by a child and a partner on a given topic and in the manner of changing topic. In general, a greater number of turns will occur in an adult-child conversation if the child, rather than the adult, initiates the topic. Topics that are sustained longer than others may suggest the child’s interest or knowledge or both. Below age 3, children rarely maintain a topic for more than two turns. In general, preschoolers take very few turns on a single topic unless enacting scenarios, describing events, or solving problems (Schober-Peterson & Johnson, 1989). More turns generally will be produced when the preschool child is directing the partner through a task or when the child is telling a story. Although the number of turns increases slightly with age, a great increase does not occur until mid-elementary school. Informativeness Each turn should add to the conversation by confirming the topic and contributing additional information. Children who have difficulty identifying the topic or determining what is expected of them conversationally may repeat or paraphrase old information, overuse continuants, or circumlocute. Circumlocution occurs when a child is unable to identify the topic or retrieve needed words and thus talks around the topic in a nonspecific manner. The SLP can rate each utterance for its contribution to the topic being discussed.

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Sequencing Once a topic is introduced, a sequence of conversational acts follows. In general, more specific information is introduced until a natural termination or a change in topic occurs. Answers or replies follow questions; comments or questions follow comments. New information is introduced and later referred to as old information. A lack of sequencing may indicate a semantic disorder or a pragmatic disorder characterized by a lack of presuppositional abilities. Further analysis of conversational turns is discussed later in the chapter. TOPIC ANALYSIS FOR MAT Several topic analysis formats have been proposed (Bedrosian, 1982, 1988, 1993; Mentis & Prutting, 1991). Each addresses different aspects of topic initiation, maintenance, and change. These are presented in Table 6.7. Topic initiation analysis may include the type of topic, the manner of initiation, the subject matter and orientation, and the outcome. Topic maintenance analysis may consider the type of turn and the ability of the client to further the conversation with the addition of new conversational information. Topic Initiation Topic initiations occur when the topic of discussion is changed in some way. Utterances on that topic express concepts subsumed by that topic. Each new topic and directly related utterances can be identified on the transcript. Type of Topic Each topic could be rated according to its novelness. Some children have a limited range of topics in their repertoire. Possible rating categories may include new, related, reintroduced, and consecutive (Bedrosian, 1982, 1988, 1993; Mentis & Prutting, 1991). New topics would be those appearing in the conversation for the first time and not linked to the immediate preceding topic. Related topics would be linked directly to the previous topic. Reintroduced topics would have appeared in the conversation previously but prior to the immediate preceding turn. Finally, consecutive topics consist of two or more topics initiated in a turn with no opportunity for the listener to maintain the preceding topic or the first of the consecutive ones to be introduced. In addition, the SLP could check with the caregivers to determine whether any of the topics introduced by the child are habitual ones. Table 6.8 presents examples of different types of topic initiation. Manner of Initiation The manner of topic initiation might include coherent changing, noncoherent changing, shifting, and shading (Bedrosian, 1982, 1988, 1993; Mentis & Prutting, 1991). Coherent changTABLE 6.7

Analysis Aspects of Topic

Topic Initiation

Topic Maintenance

Type of topic

Type of turn

Manner of initiation

Conversational information

Subject matter and orientation Outcome

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Types of Topics Initiated

Topic Type

Example

New

Partner: Uh-huh, and what else did you see at the zoo? Child: Mommy got a new car.

Related

Partner: I like monkeys too. What else? Were there any clowns at the circus? Child: I don’t like clowns. They’re scary. Partner: Clowns are scary? Why do you think clowns are scary?

Reintroduced

Child: And Ernie spilled s’ghetti all over Bert. Partner: Was Bert angry? Child: Uh-huh. And . . . and Ernie . . . And Ernie laughed. Partner: Poor Bert. That would be yukky. What else happened on Sesame Street? Child: Big Bird and Little Bird singed a song. Partner: Can you sing it for me? Child: Uh-huh. I don’t like s’ghetti on me.

Consecutive

Partner: Oh, tell me the story. Child: Okay. This little girl . . . Can you come to my birthday party? I got a new bike yesterday. Do you live here?

ing occurs when one topic is terminated and a following topic’s content is not derived from the immediate preceding topic. Noncoherent changing occurs with the absence of topic termination and/or an utterance signaling transition to a new topic. Shifting occurs when the topic being discussed serves as a source for a new topic. Shading differs from shifting in that shading is a change of focus on the same topic, rather than a discrete topic change. Table 6.9 presents the different manners of initiation. Subject Matter and Orientation The subject matter is the content of the topic initiation. Two broad analyses might consist of judgments of appropriate versus inappropriate topics for the communication context. Orientation might include topics about self, a shared experience or interest with the listener, or a topic seemingly unrelated to the listener or a shared interest. If the topic is always the speaker or always unrelated, then serious communication problems may exist. Outcome Outcomes may be rated as successful or unsuccessful (Calculator & Dollaghan, 1982). Success is dependent on the manner of initiation, the subject matter, and the form of the initiation. A command or demand is probably not a good initiation for encouraging conversational interaction. Success occurs when the conversational partner acknowledges the speaker’s topic in some way, responds, repeats, agrees or disagrees, or adds information to maintain the topic. Nonsuccess includes no response, an interruption, initiation of a new topic, or a request for repair. Although there are many variables related to success, the percentage of time that a child is successful can be an important descriptive index. Topic Maintenance Topic maintenance would be analyzed in all turns subsequent to topic initiation. Each turn can be analyzed on the basis of the continuous or discontinuous nature of the turn and on its informativeness.

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TABLE 6.9

Communication Assessment

Manner of Topic Initiation

Manner of Initiation

Example

Coherent changing

Child: And he chased the dinosaur away. Partner: What a great story. Anything else to tell? Child: I have a new baby.

Noncoherent changing

Child: Let’s have toast for breakfast. Partner: Let me fix it. Child: Those are supposed to go down. Partner: You do this one, and I’ll do the other one. Child: I’m gonna have a bowl of . . . What’s that? I think it’s a fireman hat. I wanta be a fireman. Partner: May I wear it?

Shifting

Partner: There, I’m gonna make some eggs. Child: I don’t like eggs. Partner: No, why don’t you like eggs? Child: I want some . . . some juice. I like juice. Partner: What kind of juice do you want?

Shading

Partner: Let’s have toast. Child: Where’s the toaster? Partner: I’ll cook the toast. Child: I’ll butter it. Where’s the knife? Partner: You have to find the knife. Child: It too sharp for toast.

Type of Turn. Turns may be classified as continuous or discontinuous on the basis of their linkage or nonlinkage to the topic (see Table 6.10) (Bedrosian, 1985, 1993). Continuous turns include responses to requests or questions; acknowledgments, such as uh-huh, okay, and yeah; partial, whole, or expanded repetitions; appropriate emotional responses, including laughter and crying; topic incorporation, such as the addition of more information or a request for more; shading; agreement or disagreement; and a request for repair (Bedrosian, 1985). Discontinuous turns—ones not linked to the current topic—include new topic initiations, off-topic responses, monologues, and evasion, including inappropriate use of silence. Analysis includes the frequency and range of each type of turn and the average number of turns per topic. The percentage of continuous versus discontinuous turns also would be valuable data as a descriptive value although no norms exist. (Bedrosian, 1993). Conversational Information. Turns might be analyzed for the extent to which they contribute to the development of the topic by adding relevant, novel information (Mentis & Prutting, 1991). Those adding new information include topic incorporation, such as unsolicited conversational replies that add more information or requests for new information, and answers and replies to questions that contain new information. Other turns—such as acknowledgments; requests for repair; partial, whole, or expanded repetitions; responses to requests or questions that do not contain new information; emotional responses; and agreement or disagreement—add no new information to the conversational

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Continuous and Discontinuous Turns

Type of Turn

Example

Continuous

Partner: What’s that? Child: A cowboy hat. Partner: Put it on. Child: No, it’s too hot for a coat. Partner: We have to make some bread for dinner. Child: Okay, I’ll help.

Discontinuous

Partner: Do you want to hold the baby? Child: I’ll eat my cupcake now. Partner: What else happened at school? Child: I don’t like my baby brother.

exchange. Problematic turns include word searching, incoherent utterances, ambiguous utterances, and incomplete turns. Examples of conversational information rating are included in Table 6.11. The SLP can calculate the percentage of turns contributing novel information and thus furthering the topic. Other types of turns may indicate possible problem areas. Specific strategies used by children should be investigated by analyzing the form of the utterances being used. Summary The topic analysis categories presented in this section overlap and are not always mutually exclusive. More than one turn type and informativeness category may be present in a turn. A possible analysis format is presented in Table 6.12. Each type of analysis gives an SLP an additional tool for sorting the child’s language data. TABLE 6.11

Informativeness of Turns

Informativeness

Example

New information

Partner: Where’s Mary? Child: She’s sick today. Partner: We’re going to the zoo tomorrow. Child: Monkeys live in the zoo.

No new information

Partner: And cowboys ride horsies too. Child: Ride horsie. Partner: Let’s play with the stove. Child: What? Partner: What should we play now? Child: A . . . a . . . with a . . . a . . . with a . . . you know. Partner: Who’s your teacher? Child: At school.

Problematic

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TABLE 6.12

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Possible Format for Rating Topics and Turns Turns

Categories

1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 Total

% of Total

Topic Initiation Type of topic New Related Reintroduced Consecutive Manner of initiation Coherent change Noncoherent change Shifting Shading Subject matter Appropriate Inappropriate Orientation Self Shared Unrelated Outcome Successful Unsuccesful Topic Maintenance Type of turn Continuous Discontinuous Conversational information New information No new information Problematic

TU R N TAKI NG Turn taking is an excellent vehicle for evaluating the interactional framework of a listener and a speaker. The unit of analysis is the dyad (both partners) and the interaction, rather than the individual behaviors of the child (Prutting, 1982). The rules of turn taking specify that if only two participants are involved, both have speaking turns. In general, TD children’s conversations consist primarily of this nonsimultaneous talking pat-

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tern (Craig & Washington, 1986). If more than two are involved, however, no participant is guaranteed a speaking turn. There is usually only one speaker at a time. If two or more speak simultaneously, all but one withdraw. Children with emotional disabilities may interrupt the speaker before the turn has ended, may ask and answer their own questions, and may take another speaker’s turn (Rees & Wollner, 1981). The listener pays attention to the speaker and demonstrates this behavior by turning toward or looking at the speaker, not interrupting, and/or acknowledging that he or she has heard and understood the speaker. In contrast, eye contact among children with LD and emotional disturbances is often fleeting or nonexistent. The minimum number of turns to complete an exchange is three. The person who begins the exchange must have a second turn before an interaction has occurred: for example, Speaker 1: We just returned from Florida. Speaker 2: Oh, did you go to Disney World? Speaker 1: No, we were in Fort Lauderdale. Ever been there? Each full conversational turn consists of three elements: an acknowledgment of the preceding utterance, a contribution by the present speaker, and an indication that the turn is to be shifted. In the preceding example, the previous turns are acknowledged by oh and no. Indications of turn allocation may consist of questions, intonational markers, and pauses. Transitions across speakers are orderly, occurring at transition points signaled by the participants. For example, a speaker will look at or address the listener when about to change a turn. The listener may look away, gesture, become restless, or emit an audible sigh when desiring a turn. A really anxious listener may cut off the last few syllables of the speaker’s turn without disrupting the topic. Children with LI often do not use these subtle turn indicators and miss their signal value when used by others (Rees & Wollner, 1981). Finally, the speaker who wishes to continue a turn may increase the speed or intensity of talking and continue through the transition point. If overlap occurs and interferes with understanding, the speaker “repairs” the misunderstood portion. An SLP can mark each exchange on the transcript, numbering it turn 1, 2, 3, etc. In other words, a child’s ability to initiate, add to, and terminate exchanges can be noted. Of particular interest are eye contact, turn allocation signaling, and the location and cause of exchange breakdown. In addition, an SLP can indicate the frequency, variety or range, and consistency of a child’s communication. Within each turn, the SLP notes the presence or absence of the three aspects of a full turn and the average amount of time spent in a turn (F. Roth & Spekman, 1984a). The SLP also can examine the effects of adult behaviors on the child’s conversational turns and later can help adults develop more facilitative styles. Turns may be classified as oblige, comment, or response (Coelho, Liles, & Duffy, 1991). An oblige is initiated by the speaker and demands a response. In contrast, a comment is initiated by the speaker but does not require a response. A response is a reply to either an oblige or a comment. The percentage of each category may indicate active and passive speakers, those that initiate and those that respond. All responses to obliges can be analyzed further as adequate, adequate-plus, inadequate, and ambiguous (Shadden, 1992). Adequate responses give only the information requested; they are appropriate for the request. Adequate-plus responses give more than requested, while inadequate do not give enough. Inadequate responses may be invalid, irrelevant, or insufficient. Ambiguous responses are unclear. Examples are given in Table 6.13.

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TABLE 6.13

Types of Turns

Turn Type

Example

Oblige

Do you want some cookies? What time is it? What’s that?

Comment

I really love to ski. I saw horses in the parade.

Response to comment

(Comment: This dessert is great!) It’s an old family recipe.

Response to oblige Adequate Adequate-plus Inadequate Ambiguous

(Oblige: How old are you?) I’m 25. I’m 25, and I have a master’s degree. I go to college. None of your business. Guess.

Density An SLP is interested in the density of turns within each conversation and on various topics. A low density may indicate that a child’s conversational partner dominated the conversation by taking very long turns, relinquishing them to the child only occasionally, or that the child was very reticent. Children with ASD may take relatively few verbal turns, thus leaving the partner to fill the void (Loveland et al., 1988). In contrast, if a child talked for lengthy turns, the density also would be low because the listener would have little chance to reply. Oddly enough, the rate of interrupting increases during the teen years, but the purpose changes. Increasingly, speakers interrupt not to disrupt or change the topic but to move the discussion forward to facilitate communication (Larson & McKinley, 1998). Latency An SLP can summarize the overall contingent and noncontingent latencies of a child. Whereas the average adult-to-adult turn changes within about half a second, a child may be slightly slower to react. Longer periods and/or the continual use of fillers and interjections may indicate difficulties with topic identification or word finding. Duration of Turns There is no ideal length for a turn, although most listeners know when a turn has continued for too long. We all know at least one incessant talker who does not know when enough has been said. A child who talks incessantly may be exhibiting a semantic disorder of not knowing what information is needed to close the topic, a pragmatic disorder of not knowing the mechanisms for closing a topic, or a processing problem of not being certain what information was conveyed. The SLP is interested in the average length of the child’s and the partner’s turns. Different situations, partners, and topics may yield clinically significant differences in the length of these turns.

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Type of Overlap Most turns will be nonsimultaneous (Craig & Evans, 1989). However, overlap or simultaneous speech can be very revealing. In general, overlap is of two types: internal and initial. Sentence internal overlaps are used to complete the other speaker’s turn and secure a turn. This ability requires a high level of pragmatic-linguistic knowledge. A child with LI may interrupt internally, indicating a lack of understanding of the process. The child may add new information or change the topic, rather than completing the other speaker’s utterance (Craig & Evans, 1989). Sentence initial overlaps result when a listener interjects between sentences to secure a turn. This interjection may occur when the listener is unsure of the speaker’s intention to continue or when the listener wants to gain a turn at speaking. Continual overlaps of this type may indicate a breakdown in turn taking as a result of the behavior of one or both partners. In contrast, a low incidence of interrupting, as noted among some children with SLI, may indicate passivity or an inability to initiate a “turn grab” (Craig & Evans, 1989). Frequency of Overlap Although it may seem counterintuitive, data indicate that, as a group, children with LI exhibit less simultaneous speech in their conversations (Craig & Evans, 1989). Although children with LI may be responsive, many are passive in initiating interaction or turn taking (Fey & Leonard, 1983). Duration of Overlap The adult rules for turn taking state that when an overlap in turns occurs (when two speakers speak at once), one speaker will withdraw. Young children or children with LI may continue to talk or try to outshout their partners. Some children withdraw habitually. The SLP must determine whether the child in question is more likely to withdraw or to continue talking. How Signaled? Changes in turn are signaled very subtly. A child with LI may miss such signals. Occasionally, such a child will respond only to questions, knowing that in this situation a response is required. Other children lack a basic understanding of the expectation to reply within a conversation. Still others cannot decipher the language code efficiently enough to respond. CONVE R SATION AN D TOPIC TE R M I NATION Conversations or topics are ended when no new information is added. In the case of a conversational termination, the topic is not changed. As with the opening of a conversation, there are often adjacency pairs, such as “Bye, see ya”–“Have a nice day” or “Thank you”–“You’re welcome.” Preschool children or those with LI may end the conversation abruptly when they decide it is over, occasionally just exiting the conversational context. Children with LD may not prepare the listener for the termination of the conversation by signaling with body language—for example, becoming restless, looking away, or looking at a watch. In the opposite extreme, children with LD or emotional disorder may be unable or unwilling to end the conversation and may perseverate or continue to ask questions that have been answered previously. Topics usually are terminated by shifting to another related topic. For more mature language users, this process is accomplished by shading, in which the speakers shift to another aspect of the topic or to a closely related topic, as in the following exchange: Speaker 1: I biked along the canal path yesterday. Speaker 2: Oh, I love to bike there at this time of year.

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Speaker 1: I didn’t know you bike. What sort of bike do you have? Speaker 2: I have an inexpensive 12-speed. Speaker 1: I have a 21-speed . . . The original topic of the canal bike path slid into the topic of bicycles. Whether topics are shaded or are changed abruptly, there is normally some continuity, and the new topic is stated clearly. When there is little left to discuss on a given topic, the conversation shifts. The SLP notes the method the child uses to terminate and change topics and to terminate conversations. CONVE R SATIONAL B R EAKDOWN For intervention purposes, an SLP’s analysis of the language of children with LI is an attempt, in part, to find where they are ineffectual, where they fail to communicate. It is important for an SLP to determine where these breakdowns occur and how a child attempts to repair them (Audet & Hummel, 1990). The SLP should try to determine the number of conversational breakdowns and describe the cause of breakdown, the repair attempt, the repair initiator, the repair strategy, and the outcome (F. Roth & Spekman, 1984b). Requests for Repair Requests for repair, called contingent queries, signal the listener’s attentiveness or understanding and skill in addressing the point of conversational breakdown. Conversations may be maintained by use of simple contingent queries, such as Huh?, What?, and I don’t understand. Such requests for repair maintain the conversation by indicating the point of breakdown, obligating the speaker to clarify, and specifying the appropriate form for that clarification. The type of repair request varies with the linguistic maturity of the speaker and with the information sought. In general, young children use unspecific requests, such as Huh? and What? More mature speakers try to specify the information desired, as in the following exchange: Speaker 1: We went to the zoo and saw monkeys in big cages. Speaker 2: What was in the cages? (or Where were the monkeys? Where did you go?) Requests for repair may seek repetition of the preceding utterance, confirmation, or clarification. Appropriate requests for repair and responses by the conversational partner demonstrate an awareness of the cooperative nature of conversation. Not only must a child attend to the partner’s message, detect misunderstandings, and initiate an appropriate request, but he or she also must possess the knowledge and willingness to use clarification strategies to aid the partner’s comprehension (Dollaghan, 1987). A child who continually responds with Huh? or What? may not be attending to the conversation or may have difficulty understanding. In the classroom, such children may rely on routines to make the world understandable. In this case, the child often may look around at the other children for assurance before performing the expected behavior. The SLP is interested in the degree to which a child requests additional information toward maintaining the conversation and in the form of these requests. These conversational mechanisms can be triggered in conversation by the SLP’s garbling or confusing the message. This can be accomplished by mumbling, failing to establish the topic, or providing insufficient information or confusing instructions.

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A child with LI may be unaware that communication breakdown has occurred. The SLP can hypothesize about the child’s awareness of misunderstanding and confirm the hypothesis through manipulation of utterances addressed to the child. In general, children first gain awareness of breakdowns caused by unintelligible words. The order of awareness to breakdown may be as follows (Dollaghan & Kaston, 1986): Unintelligible word Impossible command Unrealistically long utterance Unfamiliar word Question or statement without an introduction and ambiguous, inexplicit, and open-ended statements Frequency and Form In general, preschool children and those with LI, such as those with LD, tend to blame themselves, rather than the speaker, for misunderstanding (Meline & Brackin, 1987). Thus, these children use fewer requests for repair than might be expected, especially given the greater likelihood of communication breakdown. The requests produced tend to be less specific, reflecting the difficulty encountered with these forms. In short, as listeners, children with LD do not accept the responsibility to signal miscomprehension, even when taught the procedures for doing so. Instead, these children assume that the speaker will be unambiguous, informative, and clear. Children’s repair strategies can be assessed in different contexts, such as familiar topics, unfamiliar topics, and contrived pragmatic violations, by the SLP (Moeller et al., 1986). A child’s attempts to repair can be recorded on a form such as that shown in Table 6.14. Checks in the appropriate spaces would signal the child’s attempts to repair and clarify. Although there are no norms for the frequency of repair requests, general guidelines do indicate a change in both the frequency and type of contingent query with age. The earliest requests for repair are repetitions of the partner’s utterance with rising intonation (Doggie go ride?) or nonspecific requests for repetition (What?). With age, requests become more specific and increase in frequency, although both vary according to the conversational partner. With an adult partner, 24- to 36-month-olds use approximately 7 requests an hour, and 54- to 66-month-olds use approximately 14 (Fey & Leonard, 1984). When the partner is a familiar peer, the mean rate for 36- to 66-month-olds is 30 per hour (Fey & Leonard, 1984). Obviously, there is greater likelihood of misunderstanding when two preschool peers communicate. Conversational Repair Conversational repair may be spontaneous or in response to a request for repair. Preschool children spontaneously repair very little. Even in first grade, children spontaneously repair only about one-third of their conversational breakdowns. Young children or children with LI often do not attempt to repair communication breakdowns. Most 10-year-olds are able to determine communication breakdown and repair the damage. Although children with LD at that age can identify faulty messages, they do not seem to understand when to use these repair techniques. By age 2, most children respond consistently to neutral requests, such as “What?”, although they are more likely to respond if the conversational partner is an adult rather than another child. Two-year-olds also tend to overuse “yes” and thus confirm interpretations

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TABLE 6.14

Communication Assessment

Record of Requests for Repair

Clarification Skills

Familiar Topic

New Topic

Contrived Pragmatic Violation

Fails to seek clarification Indicates nonunderstanding —nonverbally puzzled expression shrugs shoulders —verbally asks for repetition says/signs What? I don’t understand I don’t remember Indicates inability to answer I don’t remember I don’t know the word for it I don’t explain it Requests specific clarification What did you say about the _____? What does _____ mean? A pattern of clarification requests may evolve as the speech-language pathologist records the number of requests by type and by conversational context of the familiar or new topic or the contrived violation. Contrived errors or violations can be used to elicit requests for clarification. Source: Moeller, M., Osberger, M., & Eccarius, M. (1986). Cognitively based strategies for use with hearing-impaired students with comprehension deficits. Topics in Language Disorders, 6(4), 37–50. Reprinted with permission.

even when incorrect, possibly because nonconfirmation requires clarification on their part. By age 3 to 5, children respond correctly, even to specific requests, about 80 percent of the time regardless of the partner (Anselmi, Tomasello, & Acunzo, 1986). Repair can provide valuable information about communication breakdowns. Breakdown can occur for a number of reasons, including lack of intelligibility, volume, completeness of information, degree of complexity, inappropriateness, irrelevance, and lack of mutual attention, visual regard, or mutual desire. As might be expected, children with LI experience a greater number of breakdowns than do agematched TD peers (Fey, Warr-Leeper, Webber, & Disher, 1988; MacLachlan & Chapman, 1988). Repairs usually focus on the linguistic structure or on the content or nature of the information conveyed. Extralinguistic signals, such as pointing, may be used to clarify. These strategies are not mutually exclusive. In general, successful outcome is related to the explicitness and appropriateness of the repair strategy chosen. When a child repairs spontaneously, the nature of the original error and the repair attempts should be noted. The SLP scans the transcript for all fillers, repetitions, perseverations, and long pauses. All of these may indicate word-finding difficulties on the child’s part. The original error or repair attempt may be based on any number of relationships with the intended word or phrase, as noted in Table 6.15. Spontaneous Versus Listener-Initiated An SLP is interested in the percentage of conversational repairs that are either self- or listener-initiated. Usually, listeners signal a breakdown with facial expression, body posture, and/or a contingent query.

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TABLE 6.15

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Relationship of Word-Finding Errors and Repair Attempts to the Intended Word

Association

Example

Definition

the thing you cook food on for stove

Description

the long skinny one with no legs for snake book holder for bookend fuzzy for peach

Generic (less specific)

do for more specific verb hat for cap, bonnet, scarf, etc. thing or one for name of entity

Opposites

sit for stand

Partial

ball . . . big ball . . . red ball for big red ball

Semantic category

stove for refrigerator (both are appliances)

Sound

t oe for t ie (initial sound similar) goat for coat (rhyme)

Strategy Immature speakers usually respond to listener-initiated requests for repair by restating the previous utterance. First graders and younger children will repeat only once in response to a request before becoming irritated. By second grade, children usually are willing to repeat twice before becoming angry. Continued requests also may result in children providing additional information, although children with LI seem less flexible in the use of this strategy (Brinton, Fujiki, & Sonnenberg, 1988). More mature speakers usually give additional information or reformulate, rather than repeat the utterance. Using their presuppositional skills, such speakers may hypothesize about the supposed point of breakdown and supply more information on this specific area. When requested to clarify, children with LI tend to respond less frequently and with less complex responses than do their peers developing typically (Brinton & Fujiki, 1982; Brinton et al., 1986). The responses of children with LI lack flexibility and usually consist of repetition with little new information included to aid comprehension. Children developing typically seem to have a greater range of repair strategies at the same age (Brinton et al., 1988). The 10-year-old child with LD is more likely to repeat, rather than reformulate, unsuccessful utterances (Feagans & Short, 1986). An SLP should prepare a list of the various types of requests for clarification and use them in conversation with a child. Of interest is the child’s rate of responding to various requests and the nature of the child’s responses (Fey et al., 1988). Frequency of Success An SLP is interested in how successfully a child identifies breakdowns, repairs them spontaneously, and follows listener requests. In general, children with LI make more inappropriate responses to listener requests than do age-matched TD peers (Brinton et al., 1988). For assessment purposes the responses of the listener determine the child’s success.

Conversational Partner Language does not occur in a vacuum. Children converse with many conversational partners, both at home and in school. Each partner helps form a dynamic context in which a child communicates and learns.

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Parent–child interactions usually offer an example of a communication process finely attuned to the language skills of a child. Thus, the adult–child dyad represents a highly individualized learning exchange based on the interactional styles and skills of the two communicators. These caregiver–child exchanges are reciprocal in that the child is treated as a full conversational partner and allowed to gain early conversational experience. Variables that affect language learning are complexity, semantic relatedness, redundancy, maternal responsiveness, and reciprocity. In general, maternal linguistic complexity seems to be related to the language learner’s level of comprehension. Semantically related utterances provide a contingency-based language-learning experience. The topic and subsequent content usually are derived from the child. Approximately 68 percent of a mother’s speech is related directly to the child’s verbal, vocal, and nonverbal behavior. The mother’s input tends to be highly redundant because it relates to ongoing contextual occurrences and attempts to explain, clarify, and comment on her child’s experiences and behavior. In addition, the caregiver may repeat content several times in different forms. Consistent maternal responsiveness teaches children that their responses and behavior have a predictable effect. One valuable lesson the child learns is that communication and communication partners are predictable. There is indication that some mothers of children with LI provide input that is not regulated by their children’s level of understanding, and thus it is significantly longer and more complex than their children’s level of comprehension. The mother’s average utterance length may be near that found in adult–adult communication and may include complex structures such as indirect directives, embedded constructions, and how/why questions. The proportion of utterances of mothers of children with LI that are related semantically is lower than that reported for mothers of TD children. In addition, the form of these utterances may be highly restricted, providing the child with a limited variety of input. Because few of the maternal utterances are related semantically, there is little redundancy. Instead, mothers tend to discuss events in the past or future and objects or events not present within the immediate shared context. Children with LI may have little effect on the conversational interaction, and their verbal and nonverbal behaviors may be ignored. Mothers may persist in introducing new topics, reflecting this nonchild-centered approach. Mothers of children with LI may be more dominant in conversations than are mothers of children developing typically, and they may initiate conversation and use directives more frequently (Loveland et al., 1988). In short, these interactions often lack the qualities of languagelearning conversational exchanges. There is a wide range in parents’ ability to interpret their children’s utterances correctly (Kwiatkowski & Shriberg, 1992). When a child’s utterances are unintelligible to a parent because of numerous phonological errors, the parent is more likely to use facilitative strategies, such as maintaining the topic or recasting the child’s utterance (Conti-Ramsden, 1990; P. Yoder & Davies, 1990). Thus, the parent takes control of the topic, allowing little opportunity for the child to initiate (H. Gardner, 1989). Especially when working with preschool children, an SLP should observe the conversational behavior of the primary caregiver and determine the language learning contributions. Utterances can be rated as to semantic relatedness, redundancy, and reciprocity. From these data, the SLP can comment on the overall teaching environment provided by the caregiver’s utterances and behaviors. It’s important to remember that being too directive or not responding in the most appropriate manner to enhance learning does not make a mom or dad a bad parent. By and large, parents of chil-

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dren with handicapping conditions face obstacles that you may not even be able to imagine at this point in your life. I credit parents for bringing their child to his or her present level of language functioning. I try to find where I can tweak the parent’s behavior or teach new behaviors to help the child continue that progress. Parents can become important allies, and demonizing them doesn’t aid this process.

Conclusion A language sample is a rich source of information on a child and that child’s conversational partners. Analysis may be accomplished at the individual utterance level, across utterance and across partner, and by conversational event. Analysis should not be attempted unless an SLP has a good understanding of the child’s language and of the caregivers’ concerns. Then a language sample would be analyzed to examine the portion of language in question. A conversational sample can be the best example of a child’s actual language use in context. Utterance-level analysis, discussed in the next chapter, is more appropriate for language form. Analysis of larger units, such as turns and topics, gives an SLP information on the use of language in context and answers questions about the efficacy of a child’s use of language to communicate. A caregiver’s style is also of interest if an SLP hopes to employ the caregiver as a language facilitator.

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Chapter 7

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I

In this chapter, we consider the broad analysis of language that can be accomplished easily within utterances by noting significant aspects of use, content, and form. These aspects are outlined in Table 7.1. In Chapter 6, we discussed analysis across utterances and partners and by conversational event. This three-tiered—across utterances and partners, by conversational event, and within utterances—analysis method seems appropriate for describing the interactive qualities of language use within the context of conversation. Language is not a “unitary construct,” but, rather, is multidimensional. It is the responsibility of an SLP to describe the unique character of each child’s language. Each utterance can be analyzed within use, content, and form categories following a variety of analysis formats (A. Johnson et al., 1984; Lund & Duchan, 1993). Individual utterances can yield the frequency and range of various features. Some data will be descriptive, whereas other data will be more normative. This situation reflects the research information available and the type of analysis desired. A number of computer-assisted and unassisted language sample analysis methods are available. Several are listed in Table 7.2. Although each method yields different data, none presents a total picture of a child’s language. In general, the more normative the results, the less descriptive and prescriptive, and vice versa. A few of the more widely used analysis methods are described in Appendix B. A generic analysis method might borrow useful portions from several of these.

Language Use As noted in Chapter 6, much language use data can be gleaned from analysis with units larger than the individual utterance. Within conversations, topics, and turns, however, an SLP can analyze the breakdowns in communication that occur at the utterance level. An SLP can analyze the breakdowns that occur within and the intentions of individual utterances.

TABLE 7.1

Analysis at the Utterance Level

Use Disruptions Illocutionary functions and intentions Frequency and range Appropriateness Encoding Content Lexical items Type-token ratio Over-/underextensions and incorrect use Style and lexicon Word relationships Semantic categories Intrasentence relationships Figurative language Word finding

Form Quantitative measures Mean length of utterance Mean syntactic length T-units and C-units Syntactic and morphological analysis Morphological analysis Syntactical analysis Noun phrase Verb phrase Sentence types Embedding and conjoining Computer-assisted language analysis

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TABLE 7.2

Communication Assessment

Language Sample Analysis Methods

Unassisted Methods Pragmatics Adolescent Conversational Analysis (Larson & McKinley, 1987) Assessing Children’s Language in Naturalistic Contexts (Lund & Duchan, 1993) Clinical Discourse Analysis using Grice’s framework (Damico, 1991a) Language functions (Boyce & Larson, 1983; Gruenewald & Pollack, 1984; Prutting & Kirchner, 1983, 1987; Simon, 1984) Syntax/Morphology Assessing Children’s Language in Naturalistic Contexts (Lund & Duchan, 1993) Assessing Language Production in Children: Experimental Procedures (J. Miller, 1981) Developmental Sentence Analysis (L. Lee, 1974) Guide to Analysis of Language Transcripts (Stickler, 1987) Index of Productive Syntax (IPSyn) (Scarborough, 1990) Language Assessment, Remediation, and Screening Procedure (Crystal, Fletcher, & Garman, 1976, revised 1981) Language Sampling, Analysis, and Training: A Handbook for Teachers and Clinicians (Tyack & Gottsleben, 1977) Semantics Profile in Semantics-Lexical (PRISM-L) (Crystal, 1982) Analysis of Propositions (APRON) (based on Johnston & Kamhi, 1984; Kamhi & Johnston, 1992; Lahey, 1988) Narratives Narrative level (Larson & McKinley, 1987) Story grammar analysis (Garnett, 1986; Hedberg & Stoel-Gammon, 1986; F. Roth, 1986; Westby, 1984, 1992; Westby, VanDongen & Maggart, 1989) Classroom-based Classroom Script Analysis (Creaghead, 1992) Curriculum-Based Language Assessment (N. Nelson, 1994) Descriptive Assessment of Writing (Scott & Erwin, 1992) Computer-Assisted Methods Syntax/Morphology Automated LARSP (Bishop, 1985) Computerized Language Analysis (CLAN) (MacWhinney, 2000) Computerized Profiling (Long & Fey, 1988, 1989) DSS Computer Program (Hixson, 1985) Lingquest 1 (Mordecai, Palin, & Palmer, 1985) Parrot Easy Language Sample Analysis (PELSA) (F. Weiner, 1988) Pye Analysis of Language (PAL) (Pye, 1987) Systematic Analysis of Language Transcripts (SALT) (J. Miller & Chapman, 2003)

DISR U PTIONS Communication breakdown or disruption can occur for many reasons. The amount and type of disruption will vary with the language task, topic, and partner(s). In general, more breakdowns occur in narration than in conversation. In addition, the longer the utterance, the more breakdowns present (MacLachlan & Chapman, 1988). Disruptions tend to occur at the developing edge of the child’s

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language where production capacity is “stretched” and there’s increased risk of processing difficulty. These utterances are of particular diagnostic significance (Rispoli & Hadley, 2001). Children with LI experience more disruptions than TD children. The frequency of disruptions is inversely related to subjective impressions of communicative competence (Damico, 1985). More disruptions are equated with less competence. In addition, disruptions can be a valuable clue to a child’s process of forming an utterance and to the level of cognitive and linguistic demands made on the speaker (Dollaghan & Campbell, 1992). Obviously, this type of analysis is not needed for all children with LI but may be helpful for those with word-finding problems or with “tangled,” slow, or too long utterances. Analysis requires that an SLP transcribe all words and word portions and all speechlike vocalizations. Pauses of 2 seconds or more also should be noted. Pauses should be obvious on a timed transcript format, as suggested in Chapter 5. All mazes should be identified. Mazes are language segments that, like physical mazes, disrupt, confuse, and slow movement—movement of the conversation in this case. Mazes may consist of silent pauses, fillers, repetitions, and revisions. Traditional syntactic analysis occurs after most mazes are eliminated and only well-formed sentences remain, this deprinting on SLP of data are communication breakdown. Analysis steps may consist of the following (Dollaghan & Campbell, 1992): 1. Identify disruptions by the categories in Table 7.3. 2. Determine the overall frequency of disruption and the frequency for each category. Each occurrence counts as one disruption. Frequency can be calculated per 100 unmazed words. Examples are included in Table 7.4. 3. Compare the frequencies to the rough normative data for school-age children and adolescents. Mean performance per 100 unmazed words: Fewer than two pauses of 2 or more seconds duration. Fewer than two repetitions. Fewer than one revision. Fewer than one orphan (see Table 7.3). Fewer than six disruptions overall. 4. Note variation in different communication situations.

• • • • •

Scoring and analysis will require training and practice. Reliability can be attained with repeated practice by two or more SLPs working side by side and comparing their analyses. I NTE NTIONS At the individual utterance level, pragmatic analysis can describe the intentions expressed and understood. The appropriateness and form of these intentions are also of interest. Although there is little normative data on the sophistication of intention form, each intention can be analyzed for its form and means of transmission. Frequency and Range Very little normative data are available on the frequency and range of intentions. This paucity reflects the contextual variability of intentions and the lack of agreement by professionals on the intentions expressed at various ages. Intentions are heavily influenced by and heavily influence the conversational context.

TABLE 7.3

Disruption Analysis Categories

Categories

Transcription

Definition and Example

Pauses Filled

Place in ()

Conventional, but nonlexical, one-syllable filler vocalizations. Example: (um), (er), (ah)

Silent

Colon & seconds

Silent interval of 2 seconds or more.* Example: Then we :3 Then we went home.

Pause strings

( ) & silent marker

Silent and filled pauses in succession. Example: So he (a-a-a-) :4 he (a-a-a-) :3 he

Repetitions Forward

[RPF]

Repetition of incomplete linguistic unit that is then completed. Example: Mom said we, Mom said we could go too. [RPF]

Partial

[RPP]

Repetition of incomplete unit with no completion. Example: So we did eat fast, did eat. [RPP]

Exact

[RPE]

Repetition of previously complete unit. Example: Mom said you have to go home, you have to go home. [RPE]

Backward

[RPB]

Repetition with additional word(s) inserted prior to repetition. Example: We went to, I mean, we went to school. [RPB]

[RVE]

Revision to correct overt incorrect information. Example: We saw monk . . . horses. [RVE]

Revisions Purposes Correct error

Add information [RVA]

Revision to add more information for better comprehension. Example: And this man he gonna cut . . . he was a doctor [RVA] . . . cut open . . .

Delete information

[RVD]

Revision to delete information for better comprehension. Example: She had cows and horses on . . . no, just cows [RVD] on her . . .

Unknown

[RVM]

Revision for unknown or mysterious reason. Example: She gave the cookies to the kids, to them kids. [RVM]

Domain affected Lexical

[L]

Change in vocabulary. Example: She love my puppies, kitties. [L]

Grammatical

[G]

Change in syntax or morphology. Example: She love, loves [G] my puppies.

Phonological

[P]

Change in phonology or articulation. Example: She woves, loves [P] my puppies.

Multiple

[M]

Change in more than one domain. Example: She wove, loves [M] my puppies.

[OP]

Seemingly unrelated stray sound(s). Example: Then man b-b-b [OP] go to . . .

Word(s)

[OW]

Seemingly unrelated stray word(s). Example: He take, eat, dog for a walk.

Word(s) and phoneme(s)

[OS]

Seemingly unrelated stray word(s) and phoneme(s). Example: I b-b-boy [OS] walk every day.

Orphans Single phoneme or string

*2 seconds is an arbitrary length. Adult pauses are much shorter. Source: Adapted from Dollaghan & Campbell (1992).

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TABLE 7.4

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Sample of disruption analysis

Partner: Do you help your parents at home? Child: My daddy, my daddy [RPE] . . . :03 I help my daddy with, my daddy to work [RVE][G]. Partner: Oh, you help your dad? What do you do? Child: He work in, outside [RVA][L] in a garden. Partner: What do you do in the garden? Child: Pull weeds and pick (um) matoes, tomatoes [RVA][P]. Partner: Um-m, I love tomatoes. I have tomato plants in my garden, too. What else do you do? Child: I do the leave stuff, the leave stuff with the [RPP] . . . :02 oh, you know [RPB] . . . :03 the thing that go like this and the leaves. Partner: You rake the leaves. Child: Yeah, and I sit, no, jump [RVE][L] and my sister. Partner: You jump on your sister? Child: Yeah, in the leaves, in the pile of leaves [RVA][G].

A number of taxonomies of intentions are available, reflecting different ages and contextual situations. I have attempted in Tables 7.5 and 7.6 to demonstrate possible changes over time. As an SLP, you may wish to develop a taxonomy based on one or a combination of the taxonomies presented. The range of intentions becomes wider and more complex with increasing age. In addition, with maturity, a child may express multiple intentions within a single utterance. Thus, a more mature speaker’s ability to express different functions is more flexible. With maturity, a speaker discusses more emotions and feelings, including such phrases as “I think . . . ,” and provides justifications. After selecting the most comfortable taxonomy or combination of taxonomies, an SLP rates each utterance of a child and conversational partner for the intentions expressed. Of interest are the conditions under which each intention occurred, possible environmental cues, and the discourse demands, such as the type of discourse (dyad, group) and nature of the task (motor, verbal, visual, or tactile) (Audet & Hummel, 1990). The normative data available, though only limited, do demonstrate that within a conversation, partners use a wide range of intentions; no intention predominates unless warranted by the situation. A child developing typically will initiate conversation and reply to the initiations of the partner, seek information and provide it, ask for assistance, and volunteer information. In contrast, some children, such as those with ASD, may initiate communication only rarely and respond with minimal replies (Loveland et al., 1988). Occasionally, adults or children fall into perseverative patterns of communicating, for example, a parent who constantly quizzes her or his child to name the pictures in a book or a child who keeps repeating a pleasing or tantrum phrase. Such behavior can skew the data or allow one type of intention, such as answers, to predominate. These patterns should be noted during conversational sample collection, and the situations gently changed. The use of different situations and different partners may ensure a better distribution of intentions. Some children, such as the incessant questioner, use only a limited range of illocutionary functions. If this behavior persists across a number of situations and partners, the SLP can be reasonably certain that this narrow range of functions represents the child’s typical behavior.

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TABLE 7.5

Communication Assessment

Illocutionary Functions of Children

Early Symbolic (below age 2)

Symbolic (age 2–7 years)

Dore (1974), Owens (1978)

R. Chapman (1981), Dore (1986), Folger & Chapman (1978)

Requesting action

Requests (for) Action/assistance/objects

Form: Command, demand

Form: Question, command, embedded command, indirect request, suggestion Permission

Regulation Protesting

Regulation Protesting Rule setting

Requesting information

Requesting information Form: Choice (yes/no), product (what, which, who . . .) Process (how, why . . .)

Replying Continuants

Replying Acknowledgments Qualifications Agreements Comments Assertives

Comments Naming

Identifications Descriptions

Personal feelings

Personal feelings Statements Reports Evaluations Attributions/details Explanations Hypotheses Reasons Predictions

Declarations

Declarations Procedurals Choice making Claims

Choice making Answers

Answers Providing information Form: Choice, product process Clarification Compliance Conversational organization

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Early Symbolic (below age 2)

Calling/Greeting

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Symbolic (age 2–7 years)

Attention getters Speaker selection Rhetorical questions Clarification requests Boundary markers Politeness Exclamations

Repeating

Repetitions

Practicing

Elicited imitations

Note: As children become older, they add new functions and continue to diversify those they already possess.

Appropriateness A very narrow intentional range may indicate inappropriate use of language. The question of appropriateness must be judged against other factors, such as age, race or ethnicity, region of the country, socioeconomic status, gender, and, most important, the communication context. The language sample can confirm the caregiver’s observation that “John seems to ask questions all of the time, even when he knows the answers.” Although the observation may not be unfounded, only data from the language sample can offer concrete proof.

TABLE 7.6

Intentions and Age of Mastery

Within Brown’s Stage I (MLU 1.0-1.99) (Usually prior to 24 months)

Answering/Responding Continuance Declaring/Citing Making choices Naming/Labeling Protesting/Denying Repeating

Emerging within Brown’s Stages II and III (MLU 2.0-3.0) (Usually at 24–36 months)

Calling/Greeting Detailing Predicting Replying Requesting assistance/Directing Requesting clarification Requesting information Requesting objects

After Brown’s Stage III (MLU 3.0 +) (Usually after 36 months)

Expressing feelings Giving reasons Hypothesizing

Sources: Compiled from Carpenter & Strong (1988); Owens (1978).

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A child who responds inappropriately may not know the linguistic context and may need more contextual cues. For example, children with LI have more difficulty responding to wh- questions than do children developing typically (Parnell, Amerman, & Harting, 1986). These children have more difficulty with both the accuracy and the functional appropriateness of their answers. Analysis of both of these types of errors is discussed in the section on contingency in Chapter 6. In general, children with LI fail to recognize the request for information inherent in questions. Even relatively simple What + be questions, such as “What is your favorite TV show?” are difficult when they concern nonimmediate or noncontextual referential sources. Thus, analysis of the context within which questions are asked is as important diagnostically as the analysis of the variety of wh- questions produced and comprehended. Encoding Intentions can be analyzed by using a means of transmission format, such as verbal/vocal/nonverbal (F. Roth & Spekman, 1984a). The transition from linguistic through paralinguistic to nonlinguistic can be used to describe a hierarchy of competency or effectiveness based on a child’s developmental level. The nonlinguistic context and behaviors of the conversational partners must also be transcribed to make this information available. In general, a child with poor linguistic skills will rely on other means of communicating intentions. Although some very sophisticated information can be communicated nonlinguistically, as in the popularly named pregnant pause, less mature language users tend to depend on nonlinguistic and paralinguistic means more than do mature users. As with the various intentions expressed, a range of transmission means should be exhibited by the child and partner. If a child uses an augmentative form of communication, that form should be specified even more and might include physical manipulation of an object, physical manipulation of a partner, gestures, and signing or use of an augmentative device. Two children described as nonverbal may have very different means of communicating their intentions.

Content The understanding of word meanings and word relationships is affected by many factors, such as age, gender, and regional and racial/ethnic differences. To know a word is to know more than just a definition. It means a child understands that word’s relationship to similar words of meaning and sound and to words of an opposite meaning and understands the semantic class into which the word can be placed. Meaning extends beyond the word, however, and larger units of analysis, such as the phrase or sentence, also must be considered. What is said—for example, “Don’t hit me”—may be very different from the intended message, which might be “Go away, I don’t understand what you want.” Obviously, all of this information cannot be ascertained from a brief language sample. Word understanding can be assessed across several sessions by playing games like Simon Says or by directing a child through a series of tasks. The SLP can make statements in which words obviously are used incorrectly in order to judge the child’s reactions. Word games that solicit definitions or antonyms also can provide valuable information. Sorting and categorization tasks can be part of a play situation and can provide information on the child’s ability to categorize and classify. The child can be asked to name the members of a category or to deduce the category name from a list of members. The SLP can play the “fool” and make ridiculous comparisons (“A mouse is bigger than an elephant”) or silly pairings (“The comb goes between his toes”) to gauge the child’s reactions.

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Vocabulary abilities are strongly related to reading comprehension (Curtis, 1987; Nagy & Herman, 1987). Reading and writing analysis is discussed in Chapter 13. The child with semantic difficulties also may exhibit academic and reading failure, especially with Comprehension. Although children with LI and with LD usually do not have difficulty with referent-symbol tasks, such as those represented by the Peabody Picture Vocabulary Test, they may have difficulties, with double meanings, abstract terms, synonyms, and nonliteral interpretation (Seidenberg & Bernstein, 1986). In addition, the physical setting can be especially important for children with LI because they depend on the context for support. The child may understand a word only given certain physical situations or contexts. It may be best to assess definitions in formal decontextualized activities, such as testing, but word use in conversations, where context can influence behavior, can also indicate correct usage. Between ages 5 and 10, the nature of definitions changes from functional to categorical and more elements are added. By second grade, 49 percent of definitions include categorical membership, such as an apple is a fruit, increasing to 76 percent by fifth grade (Nippold, 1995). Multiple definitions are more difficult to interpret in a decontextualized or isolated format because of the use of content to disambiguate (C. Johnson, Ionson, & Torreiter, 1997). In general, sentence format aids performance but this varies with word type. Words with multiple definitions appear frequently. For example, 72 percent of the 9,000 most frequent words in one elementary reading series had multiple meanings. LEXICAL ITE MS Obviously, there are several levels of semantic analysis relative to individual words and relations between words and larger units. At the word level, a child demonstrates individual word meanings and word classes. Several questions arise relative to word use and the range of meanings and relationships. Norms are difficult to establish, especially for older school-age children and adolescents because of the individualistic nature of lexical growth. In addition, increases in vocabulary occur at a slow and steady pace into adulthood. School-age children and adolescents exhibit semantic development in the following areas (Scott, Nippold, Norris, & Johnson, 1992): of literate verbs, such as interpret and predict • Comprehension Comprehension textbook terms, such as invertebrate and antecedent • Comprehension ofof adverbs magnitude, such as slightly and unusually • Comprehension of adverbialofconjuncts, as meanwhile and conversely • Comprehension of sarcasm based on its such linguistic as well as intonation • Comprehension of slang terms used by peers, suchaspects, as phat • Comprehension of complex proverbs • Comprehension of complex metaphors • Explanation of infrequently occurring idioms, such as to vote with one’s feet • Explanation of ambiguous messages • Definition of abstract concept words, such as courage and justice • Type-Token Ratio The type-token ratio (TTR) is the ratio of the number of different words to the total number of words. The number of different words (NDW) in a sample of fixed length is strongly correlated with age and

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measures of semantic diversity (J. Miller, 1991). Significantly lower values than those in Table 7.9 might suggest retrieval problems or poor vocabulary. The total number of words (TNW) also increases steadily with age and is a general measure of verbal productivity (J. Miller, 1991). For example, 3-year-olds use 205 words in 50 utterances, while 8-yearolds use 379. Although a general measure of ease of language use, TNW also is affected by other factors, such as motor ability and word retrieval. For these reasons, the validity of TNW as a measure of preschool language development has been questioned by some professionals (Gavin & Giles, 1996). (Values of TNW for a 20-minute sample are listed in Table 7.9) As a quantitative measure, TTR has had a checkered past of professional acceptance. This uncertainty reflects recognition that the value may vary widely with the language sample size. In general, less variability is found across larger samples of 350 words or more (Hess et al., 1986). Multiple settings and more representative samples would yield theoretically more stable values, although there may be great situational variability for an individual child (Hess, Haug, & Landry, 1989). Children between ages 2 and 8 demonstrate TTRs of 0.42 to 0.50 (Klee, 1992). Children who receive values greater than 0.50 have greater variability and flexibility in their language, whereas those below 0.42 tend to use the same words over and over again. Very low values may indicate perseverative or stereotypic behavior, word-retrieval problems, or restricted vocabulary. Children with LEP also may score lower because of their lack of English vocabulary. A low value may indicate overreliance on words with broad application but unspecified meaning (empty words), such as thing and one. Children with poor vocabularies or word-finding difficulties may use empty words, rather than more specific words that are not at their disposal. Two spontaneous language profiles emerge from the samples of children with word-finding problems (German, 1987). Some children exhibit word-finding difficulties both on structured naming tasks and in spontaneous samples. They exhibit reformulations, time fillers, empty words, repetitions, starters, and grammatical errors. Other children with LI exhibit these behaviors only on structured naming tasks, although they produce relatively less language in spontaneous samples than do children developing typically. Mature speakers should possess a variety of words for describing sensory experiences, such as sight (clearly), sound (loud), smell (stunk), and feelings (happy, tired). They should be able to describe the environment in terms of time (at five o’clock) and location (in front of). Entities should possess physical qualities, such as shape (sort of round), size (big), number (two, many, few), substance (metal, wood), and condition (new, ragged). There should be terms for relationships, such as comparisons (bigger than, as big as) and qualifications (nearly, not quite, only, enough); and verbs for describing actions (run, jump, eat), states (am, is, are), and sensory processes (feel, hear, see). Finally, the speakers should be able to describe causation (because . . .) and motivation. As noted previously, these terms develop slowly. The full range is characteristic of the mature speaker. Deictic terms, or terms that must be interpreted from the perspective of the speaker (e.g., here, there, this, that, come, go), offer a special problem for the child with LI. The shifting reference that occurs with each speaker change contributes to the child’s difficulty. Children with LLD, ASD, or emotional disturbances may lack either the listener or speaker perspective. These children also may refer to themselves by name and may echo the utterances of others. No one measure, such as type-token ratio, should be used in isolation. This is especially true for children from CLD backgrounds. Although type-token and its component parts, total number of words and number of different words, can be used to differentiate the narratives of typical language from impaired language for monolingual children, they do not do so for bilingual Spanish-English preschool

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children (Muñoz, Gillam, Peña, & Gulley-Faehnle, 2003). Other measures, such as syntactic accuracy, may be more appropriate. Over-/Underextensions and Incorrect Usage An SLP should note all inaccurate uses of words that indicate some variation between a child’s meaning and the conventional one. In general, meanings mature from the concrete, personal, experiential ones found in preschool children to the shared, conventional, abstract ones of adults. Some children use words incorrectly because they do not know the shared conventional definition. Others use word substitutions that are incorrect. For example, a recent letter from a young adult with LD included the following: I wish I could write as good as you. You know where to put paragraphs and how to use punctuality [my italics] right. Because I am usually late, I assume he meant punctuation. Further testing by an SLP can reveal the basis of a child’s substitutions. The child may miss the target word slightly, as in the above example, or may have word-finding difficulties, resulting in word substitutions. Children with LEP may use L2 words in either very restricted or overextended ways. Restricted use may be limited to specific features of a word or to word-for-word transfer in which the word has only the meaning of its L1 equivalent. In the latter, for example, the English for, which is para in Spanish and has slightly different syntactic uses, might be used only where para would be used. Style and Lexicon Children begin to use different styles of talking relatively early. Analysis across utterances and partners might highlight a conversational style shift. These changes can be analyzed further for the vocabulary used in different styles. Slang is a casual manner of spontaneous conversation among peers and is important for adolescents. Used appropriately, slang separates adolescents from children and adults and establishes group identity and solidarity (Cooper & Anderson-Inman, 1988). Certain vocabulary—rad, phat, bad—is characteristic of adolescent slang. Word meanings change quickly and are invented often by youth (R. L. Chapman, 1987). Knowledge of slang vocabulary increases with age, with boys knowing more terms for vehicles and money and girls for clothing, boys, and unpopular individuals. An adolescent with LI may seem odd in peer situations because he or she underuses or overuses adolescent slang or uses it inappropriately. Although difficult to assess because of its changing nature and subgroup use, slang is, nonetheless, extremely important. In brainstorming sessions, TD teens can suggest vocabulary targets for assessment and training. The child’s literate vocabulary, consisting of words primarily used in common academic contexts, is also important. A good, literate lexicon is needed to achieve academic success, especially among adolescents (Nippold, 1993). Possible lexical items are analyze, criticize, deduce, define, infer, interpret, predict, remember, and understand. Classroom teachers can suggest other useful literate terms. WOR D R E LATIONSH I PS Each word in a language is related to other words. These relationships consist of word associations (e.g., salt and pepper or king and queen), synonyms, antonyms, and homonyms. Some of these associations

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are expressed in a conversational sample, whereas others need to be probed by an SLP. These associations reflect underlying cognitive organizational strategies. Semantic Categories Semantic categories, such as agent, action, and location, are the earliest word classes children use. Indeed, most of the early language development of toddlers is concerned with semantic units. Several categorization schemes attempt to describe the semantic classes of young children and adults. Table 7.7 is a composite of the range of semantic categories expresssed by children that SLPs are interested in. Semantic knowledge, the underlying concepts, may be a better framework than language form for assessment children with minority dialects, including African, Latino, and Asian American English and Appalachian English. The adequacy of the semantic knowledge of these children is often questioned on the basis of the form of their language. It is assumed, incorrectly, that minority dialect speakers acquire concepts later than do speakers of dialects closer to Standard American English (SAE). The developmental trends are very similar and suggest guidelines for assessment of the semantic features of speakers of minority dialects (Stockman & Vaughn-Cooke, 1986). Intrasentence Relationships In addition to an interest in a child’s word meanings and relationships, an SLP investigates other relationships expressed in the sentence through the use of conjunctions, negatives, and prepositions (Lund & Duchan, 1993) and various sentence forms, such as passive voice. Conjunctions Four types of conjunctive relations are expressed in conjoined sentences (Bloom, Lahey, Hood, Lifter, & Fiess, 1980): additive, temporal, causal, and adversative. In the additive form, two clauses with no dependent relationship simply are joined to one another. In the sentence “Julio ate pie, and Brigid drank coffee,” neither event depends on the other for its existence. In the temporal form, one clause depends on the other to precede or follow or occur at the same time. In “I’m going to the store before I go to the party” or “I’ll rake the leaves while you finish painting the trim” the timing of the clauses is clearly stated. Causal conjoining implies a dependency in which one clause is the result of the other, for example, “I went to the party because I was invited.” The preschool child may use because alone or at the beginning of a clause, as in “Cause I want to,” although true causal conjoining occurs much later (see Table 7.16). Finally, in adversative conjoining, one clause contrasts with information in the other, as in “I read the article, but I was unimpressed.” One clause opposes or negates the other.

TABLE 7.7 Semantic Function

Action

Semantic Categories

Description

Example

The predicate expresses action with a transitive or intransitive clause.

We grew pumpkins and squash. (Transitive) She gave us a dollar. (Transitive) He swims daily. (Intransitive)

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Description

Example

State

The predicate makes a statement about the way things are with a transtive, intransitive, or equative clause.

I want a hot fudge sundae. (Transitive) Tigers look fierce. (Intransitive) She is tall. (Equative) My sister is now at Harvard. (Equative)

Agent or actor

Animate instigator of action. Sometimes inanimate, especially if natural force. Usually the subject but may also be passive complement.

Mike threw the ball. Termites destroyed our cabin. Wind blew down the trees. The cat chased the dog. The dog was chased by the cat.

Instrument

Usually refers to the inanimate object used by the actor to effect the action stated in the verb. The actor is usually not stated but may be. The instrument function may also be adverbial, as in on his drum.

The axe split the wood. The building was erected by a crane. She used the baseball bat with great skill. The axe split the wood. The shaman kept rhythm on his drum.

Patient

The entity on which an action is performed. The patient may be a direct object in transitive clauses or the subject in intransitive clauses.

Mike threw the ball. The lighthouse withstood the hurricane.

Dative

The animate recipient of action. Usually the indirect object but may also be the direct object if it does not undergo any action but receives something.

Father bought mother a bouquet of roses. Our mascot brought us good luck. He built a treehouse for his daughter. I loved that movie.

Temporal

Fulfills the adverbial function of time in response to a when question. May also be the subject of a sentence or a complement.

I’ll see you later. We’ll meet at four o’clock. Then, I’ll know. Tomorrow is a holiday. Tuesday will be our first meeting. It is time to leave.

Locative

Fulfills the adverbial function of place in response to a where question. May also be the subject of a sentence or a complement.

Some of us looked in the old log. I knew it was right here. Chicago is indeed a windy city. Our house has three bedrooms.

Manner

Fulfills the adverbial function of manner in response to a how question.

We stalked the big cat carefully. He worked with great skill.

Accompaniment

Fulfills the adverbial function of with X in response to with whom or with what questions.

He swam with his sister. She left with Jim. He hunted with his dogs.

Empty subjects

Serve a grammatical function.

It was sunny. There may be some rain.

Source: Adapted from Chafe (1970); Fillmore (1968).

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Negatives Negatives may be expressed in several ways and develop at different stages. The four mature negative forms include (a) not and -n’t; (b) negative words, such as nobody and nothing; (c) the determiner no used with nouns; and (d) negative adverbs, such as never and nowhere. Again, the more mature language user should have a variety of forms. Those used by the child can be compared with the developmental data available in Table 7.16. Prepositions Prepositions are some of the hardest working and most versatile English words. They can be used to mark location (in the box), time (in a minute), or manner (in a hurry) to fill adjectival and adverbial functions, and to make figurative expressions. These small, often unstressed words may be misinterpreted or misunderstood by children with both LI and LEP. A strategy they use is overreliance on one form. As mentioned previously, an SLP examines the sample for the breadth of use. Passives In general, children with LI exhibit difficulty interpreting sentences in which the information might be interpreted in a reverse manner (van der Lely & Harris, 1990). For example, a passive sentence, such as “The cat is chased by the dog” might be interpreted incorrectly as “The cat chased the dog” by using a agent-action-object interpretation strategy. Children with LI have difficulty interpreting the grammatical functions of words and integrating grammatical and semantic information. FIG U RATIVE LANG UAG E Nonliteral meanings used for effect are more characteristic of school-age and adult language than of preschool language (Nippold, 1988; Nippold & Martin, 1989). Examples include metaphors, similes, idioms, and proverbs. For the purposes of analysis, jokes and puns also can be considered figurative language. Figurative language occurs frequently in oral conversation and written texts and interpretation of idioms is highly correlated with reading ability. Children as young as 31⁄2 are able to comprehend some idioms, especially the more literal ones (Abkarian, Jones, & West, 1992). In general, figurative interpretation increases with increasing age. Individual interpretive ability is related to each person’s world knowledge (Winner, 1988). For example, smooth sailing has more meaning for the child who has some boating experience. Idioms occur frequently in the classroom. There may be as many as four figures of speech per speaking minute. Teachers use idioms in approximately 11 percent of their utterances, while third- to eighth-grade reading programs contain idioms in approximately 6.7 percent of their sentences (Lazar, Warr-Leeper, Nicholson, & Johnson, 1989). Idioms differ greatly in their difficulty of interpretation. In general, more familiar and more transparent or guessable idioms are easier. The child’s world and word experience appear to be a key factor in interpretation (Nippold & Rudzinski, 1993). An SLP considers the range of figurative language used. Some children overrely on well-worn phrases and expressions, with little knowledge of their actual meaning. Such expressions as these can be probed by an SLP to determine a child’s actual knowledge. Comprehension and production of idioms might be analyzed on the basis of decomposability of the idiom. Decomposable or analyzable idioms can be broken easily into their component parts. For example, pop the question or let off steam can be broken into components that each contribute to the overall meaning, as follows: pop the question

pop = act of uttering questions = marriage proposal

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let off = release steam = energy

Nondecomposable idioms, such as kick the bucket, are difficult to break into components. Comprehension depends on a child’s intuition about the internal semantics of the idiom. In general, young children are better able to interpret decomposable idioms than nondecomposable. Third and fourth graders do equally well on both types in context. If no contextual information is available, these children also are better able to comprehend decomposable idioms (Gibbs, 1991). Analysis of figurative language is especially important for children with LEP. Idiomatic expressions may be interpreted literally and/or based on cultural interpretation. WOR D FI N DI NG Word-finding difficulties are an impaired ability to generate a specific word that is evoked by a situation, stimulus, sentence context, or conversation. In Chapter 3 we discussed a method of probing for word-finding difficulties and strategies. In Chapter 6 we noted that latency may signal such difficulties. Other symptoms include frequent pauses, repetitions, circumlocutions, fillers, nonspecific words, frequent pronouns, and high usage of cliches and routinized expressions, such as you know (Bates et al., 1988; Snyder & Godley, 1992). Inaccurate naming may be analyzed using the strategies presented in Table 3.7. Word-finding difficulties relate to several aspects of the target words, such as word frequency, age of acquisition, familiarity, and lexical neighborhood (German & Newman, 2004). Neighborhood density, or the number of words that differ from the target word by only one sound, is particularly important. Words such as rat have many neighbors: cat, bat, fat, gnat, sat, hat, mat, rap, ran, rot, wrote/rote, write/right, rate, and so on. The neighborhood is very dense. Both children and adults find it easier to produce and remember words that are phonologically similar to words already known. If neighbors are high-frequency words, recall is enhanced even more. In contrast, word substitutions tend to be words that have a higher frequency, are learned earlier, and also reside in dense neighborhoods with other high-frequency words. Blocked words, or those a child is unable to retrieve, tend to reside in sparse neighborhoods. Phonological errors tend to occur on rare words and those whose neighbors contain lower frequency, uncommon phonological patterns. Several intrinsic and extrinsic variables affect word-retrieval skills. Intrinsic variables include the frequency of occurrence of the word, familiarity with the word, age of acquisition, category, and degree of abstractness. In general, more frequently used, more familiar, earlier learned, and less abstract words are easier to retrieve (Stowe, 1988). Words from large prototype categories, such as fruits and vegetables, are easier to retrieve than those from well-defined categories, such as months, based on a small set of specific features. In actual use, categories overlap and relative importance for naming will vary. Extrinsic variables include the context, syntactic requirements, type of stimulus and manner of presentation, priming, and use of categories. In general, sentence contexts are easier than picture ones, which, in turn, are easier than definitions. Formulation of more difficult sentences, however, interferes with word recall, probably because of the greater cognitive energy needed to form the sentence. Priming results when preceding words aid recall (Balota & Duchek, 1989; Glass & Holyoak, 1986). Finally, use of subordinate categories can aid word recall (Kail, Hale, Leonard, & Nippold, 1984). The effect of these variables can be very important and difficult to assess in a language sample. It is important, therefore, to use familiar partners, topics, and situations to facilitate retrieval.

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Form Language form includes syntax, morphology, and phonology, or the means used to encode the intentions and meanings of a speaker. Even though most language analysis methods concentrate on this aspect of language, very little normative data is available. The task is partially normative and partially descriptive, involving both quantitative and qualitative analysis. Several available analysis methods are described in Appendix B. A discussion of phonological analysis is beyond the scope of this text. QUANTITATIVE M EASU R ES Quantitative measures include mean length of utterance (MLU), mean syntactic length (MSL), T-units and C-units, and the density of sentence forms. Each is discussed in some detail. The SLP must be cautious with all word and morpheme counts. Careful editing of utterances is required so that interjections, false starts, and the like are not included in the count. Circumlocutions, or talking around an unretrievable word, actually may increase the length of the child’s utterances. It is recommended that an SLP follow consistent rules for counting. For example, incomplete words, nonessential repetitions, revisions not containing a complete thought, unintelligible words and phrases, and fillers might be offset in brackets and not counted. These structures are retained, however, for disruption analysis. Quantitative measures may present some problems (Scott & Stokes, 1995). In general, there can be wide variability across children and situations. In addition, many values change only slowly with age. Still, average words per sentence values increase from 7 to 14 between third and twelfth grade. Combinations of quantitative data may yield better information than individual bits of information. For example, MLU, percentage of utterances containing one or more errors of morphology or syntax, and chronological age seem to be optimal for predicting clinical diagnosis of SLI (Dunn, Flax, Sliwinski, & Aram, 1996). Structural errors might include word misordering; omission or incorrect use of a morpheme; omission of articles, auxiliary verbs, or contractions; use of telegraphic speech; or incorrectly selected negatives. Children between the ages of 49 and 53 months may have MLU values of 4.1 compared to 3.12 for those with SLI. The percentage of utterances with structural errors is 10.97 and 23.56 respectively. Mean Length of Utterance Mean length of utterance is the average length in morphemes of the speaker’s utterances. Up to an average of 4.0, MLU is considered a good measure of language complexity. Not all linguists agree (J. Johnston & Kamhi, 1984; Klee & Fitzgerald, 1985; Lahey, 1994). Although the reliability of MLU has been questioned and the values vary in response to SLP input, MLU has been shown to be both a reliable and valid measure of general language development through age 10 for children with SLI (Rice, Redmont, & Hoffman, 2006). In general, there is less variability in MLU below 4.0 (Rondal, Ghiotto, Bredart, & Bachelet, 1987). This mean is reached by the nonimpaired child at around age 4, but MLU continues to increase with age. At lower MLUs, new structures added to the child’s utterances increase the complexity of those sentences. After this level of development, much of the growth in complexity is the result of internal reorganization of utterance form, rather than addition of new structures. This explanation of the relationship between length and complexity is extremely simplified, and there are many related factors.

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To calculate MLU, an SLP divides the language sample into utterances. It is best not to include in analysis the portions of conversation that occurred while the child was adjusting to the partner or to the situation. The number of morphemes in each utterance is counted and totaled for the entire sample. Rules for counting morphemes on the basis of the order of development with nonimpaired children are included in Table 7.8. Brief rationales for these rules are included where appropriate. The total number of morphemes for the entire sample is divided by the number of utterances from which it was derived to determine the MLU. This value then can be compared to the age data in Table 7.9. It is obvious from the table that a wide variability and a wide range of ages are considered

TABLE 7.8

Rules for Counting Morphemes Relative to the Speech of Preschool Children

Structure

Example

Count

Rationals

Each recurrence of a word for emphasis

No, no, no.

1 each

Compound words (2 or more free morphemes)

Railroad, birthday

1

Compound words learned as a unit by preschoolers

Proper names

Bugs Bunny, Uncle Fred

1

Proper names, even those with titles, learned as a unit by preschoolers

Ritualized reduplications

Choo-choo, Night-night

1

Irregular past tense verbs

Went, ate, got, came

1

Verb tense learned as new word by preschoolers, not as verb + ed

Diminutives

Doggie, horsie

1

Phonological form CVCV easier than CVC for preschoolers and does not denote smallness

Auxiliary verbs and catenatives

Is, have, do; gonna, wanna, gotta

1

Preschoolers do not know that such words as gonna are going to

Contracted negatives

Don’t, can’t, won’t

1–2

Because negatives don’t, can’t , and won’t develop before do, can, and will, count as one until the positive form appears. Then count the negative forms as two morphemes. All other negatives—couldn’t—count as two.

Possessive marker (-’s)

Tom’s, mom’s

1

Plural maker (-s)

Cats, dogs

1

Third-person singular present tense marker (-s)

Walks, eats

1

Regular past tense marker (-ed)

Walked, jumped

1

Present progressive marker (-ing)

Walking, eating

1

Dysfluencies

C-c-candy, b-b-baby

1

Fillers

Um-m, ah-h

0

Count only the final complete form.*

*In the example “I want can . . . I want can . . . I want candy,” only the last full reduction is counted, being three morphemes.

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within the normal range. Even so, the need to collect a typical sample is very important. If data have been collected in two or more settings, the MLUs from each can be compared to assess the stability of the overall data. Although age and MLU are correlated as shown in Table 7.9, some interesting data suggest cautious acceptance of this correlation. First, the relationship of rate of MLU change and age is not a constant, as seen in Table 7.9. Second, some language impairments are not evidenced by delays in MLU as might be expected (Klee, Schaffer, May, Membrino, & Mougey, 1989). As with any single measure, MLU alone is a poor diagnostic tool and the validity and reliability of results will vary with the sample size (Eisenberg, McGovern Fersko, & Lundgren, 2001). Standard errors of measure may differ .19 at 18 months to .71 at 60 months based on a 50-utterance sample. Values are less for 100 utterance samples. Nor is a low MLU necessarily indicative of language impairment. Utterance length may vary with the situation, and some children with LI, especially those with circumlocution or empty words, may have inflated MLUs. Mean Syntactic Length Mean syntactic length (MSL) is the mean length in words of all utterances of two words or more—those utterances with some internal grammar. This measure eliminates all one-word responses, such as yes/no answers. MSL seems to correlate more strongly than MLU with age (Klee & Fitzgerald, 1985). Values for MSL are listed in Table 7.9 (Klee, 1992). TABLE 7.9

Quantitative Measures of Language

Age in Months

MLU

*Range of Mean MLU

18 21 24 27 30 33 36 39 42 45 48 51 54 60 108

1.1 1.6 1.9 2.1 2.5 2.8 3.1 3.3 3.6 3.8 3.9 4.1 4.3 4.4 8.8

1.0–1.2 1.1–1.8 1.6–2.2 1.9–2.3 2.4–2.6 2.7–2.9 3.0–3.3 3.2–3.5 3.3–3.9 3.4–4.3 3.6–4.7 3.7–5.1 3.9–5.8 4.0–6.0 7.2–10.4***

**MSL

**TNW (20 min.)

**NDW (50 utt.)

2.7 2.9 3.1 3.4 3.7 3.9 4.2 4.4 4.7 4.9 5.2

240 286 332 378 424 470 516 562 608 654 700

36 41 46 51 56 61 66 71 76 81 86

TTR (type-token ratio) changes little with age but is in the range .42–.5 for 2- to 9-year-olds. *Combined data from four different studies (Klee, Schaffer, May, Membrino, & Mougey, 1989; J. Miller, 1981; Scarborough, Wyckoff, & Davidson, 1986; Wells, 1985) **MSL (mean syntactic length), TNW (total number of words), and NDW (number of different words) extrapolated from tables in Klee (1992). ***From J. Miller, Freiberg, Rolland, & Reeves (1992)

Chapter 7

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195

T-Units and C-Units Expressive language syntax of older children and adolescents can be measured in T-units (minimal terminal units), consisting of one main clause plus any attached or embedded subordinate clause or nonclausal structure (discussed in the following section). Thus, the unit has shifted from the utterance to the sentence in its shortest allowable form. Any simple or complex sentence would be one T-unit, but a compound sentence would be two or more. For example, the sentences “I want ice cream” and “I want the one that is hidden in the blue box” each constitute one T-unit with varying numbers of words and clauses. “I want the ice cream in the picture, and he wants a shake” consists of two main clauses and thus two T-units. Examples of T-units are given in Table 7.10. The T-unit is more sensitive than MLU to the types of language differences seen after age 5, such as phrasal embedding and various types of subordinate clauses. Throughout the school years, a slow but regular increase occurs in sentence length in both oral and written contexts. Children’s language can be described in words per T-unit, clauses per T-unit, and words per clause. A gradual and progressive increase in words and clauses per T-unit and in words per clause in spontaneous speech occurs with increased age throughout childhood and adolescence, although the values change only gradually during early school years (see Table 7.11) (Klecan-Aker, 1985; Scott et al., 1992). The values for spoken words/T-unit and clauses/T-unit are similar for Spanish. To calculate these values, the SLP divides the sample into sentences, each equaling one T-unit. The number of words and clauses then can be determined for each and divided by the number of T-units to calculate an average. The words per clause can be determined similarly. It should be noted that the type of conversational task will influence some T-unit measures. Information-giving tasks increase the words and clauses per T-unit. In addition, at this level of development, T-unit values can be misleading because complexity and length are not directly related. For example, among adolescents, phrases may be used in place of subordinate clauses for conciseness, suggesting greater syntactic sophistication (Nippold, 1993). These include participial phrases (Working until midnight, John missed his bus), infinitive phrases (Candace was not afraid to use the computer for typing her assignment), and gerund phrases (Seeing your photos convinced us that we should go to Puerto Rico) (Scott, 1988b).

TABLE 7.10

Examples of T-Units and C-Units

Sentence Structure

Example

Number of T-units and C-units

Simple—one clause

They watched the parade on TV.

1 T-unit, 1 C-unit

Complex—embedded clause

Washington has the horse I want.

1 T-unit, 1 C-unit

Compound—conjoining of two or more clauses

They went to the movie, but I stayed home. Mom went to work, I went to school, and my sister stayed home.

2 T-units, 2 C-units

(Who went with you?) Marshon. Oh, wow! A penny saved.

1 C-unit 1 C-unit 1 C-unit

Partial sentences Elliptical answers Exclamations Aphorisms

3 T-units, 3 C-units

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A variance of the T-unit is the C-unit. C-units are similar to T-units but also include incomplete sentences in answer to questions (Table 7.10). C-unit values are given in Table 7.11. The length increase in C-units is primarily through the increased use of low-frequency structures. These include post-noun modifiers, such as apposition structures (Mary my instructor showed us . . .) and prepositional phrases (The man in front is . . .), complex nominals (Dogs and cats can . . . or Rules such as stop on red are . . .), and elaborated verb tensing, such as modal auxiliaries (could have been), perfect aspect (had been working), and passive voice (The window was broken by a fly ball). Analysis of these structures might accompany calculation of C-unit values. Although data are not complete, some values for T-units and C-units have been calculated for children speaking primarily African American English and Spanish. These are presented in Table 7.11. Children speaking AAE demonstrate infinitive phrase embedding and clausal embedding at an early age. Three-year-olds have one or more complex syntactic forms in 6.2 percent of their utterances, while 4-years-olds increase that to 11.7 percent (Jackson & Roberts, 2001). Additional values include mean number of morphemes per C-unit for AAE speakers (Craig, Washington, & Thompson-Porter, 1998): Age 4 5 6 Preschool Kindergarten

TABLE 7.11

Mean Morphemes/C-Unit 3.48 3.76 4.24 3.55 3.98

T-Units and C-Units by Age and Grade

Units

Words/T-unit Spoken Oral Spanish Written Words/C-unit Oral Oral AAE Written Clauses/T-unit Spoken Written Subordinate Clauses/C-unit Spoken Written Words/Clause Spoken Written

Age 4

Age 6

Grades 3–4

7.8

Grades 6–7

Grade 9

9.7

Grades 10–12

11.4

5.64 9.5

3.14

9.4–11.8

10.6–14.3

9.82

10.96

11.7

9.04

10.05

13.27

3.81

1.26

1.31 1.3

1.5 1.6 .37 .29

7.14

1.5 1.6–1.8 .43 .47

.58 .6

7.75 7.26

Source: Adapted from Crowhurst & Piche (1979); Scott, Nippold, Norris, & Johnson (1992).

8.82

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197

Number of errors per T-unit was also found to be a significant value for predominately Spanish-speaking children (Restrepo, 1998). Five- to 7-year-old Spanish-speaking children developing typically made only .09 (S.D. = .05) errors, while those with LI made .39 (S.D. = .21).

SYNTACTIC AN D MOR PHOLOG ICAL ANALYSIS Many children with LI experience difficulty with syntax and morphology. For example, children who are mildly to moderately behaviorally disordered seem to have word-order difficulties (Camarata, Hughes, & Ruhl, 1988). It should be noted that some utterances defy analysis, such as those containing contrasting stress used to negate. For example, one speaker might say, “Penny went,” only to be corrected by the other speaker with “Mary went.” At a syntactic level, these two sentences would appear to be similar. Morphological Analysis An SLP is interested in intraword development, as well as in sentence development. With preschool children, the SLP will want to analyze Brown’s fourteen morphemes for correct production. These are listed in Table 7.12. Other morphemes, such as pronouns, also may be of interest. Older children may use a variety of morphological prefixes and suffixes. A list of the more common prefixes and suffixes is included in Appendix C. Correct usage of Brown’s fourteen grammatical morphemes can be a clinical aid for establishing the developmental stage of preschool children (J. Miller, 1981). Table 7.12 presents the morphemes by stage of mastery, the stage in which each morpheme is produced correctly by children in 90 percent of the obligatory contexts. The percentage correct value is determined by dividing the number of correct appearances by the total number of obligatory contexts. In obligatory contexts, the child might use the morpheme correctly, make an error substitution, or omit the morpheme. Table 7.13 presents selected portions of a language sample and the calculation of percentage correct for the regular plural marker. The percentage correct yields only limited data. More descriptive information can be gained. For example, an SLP who calculated only the percentage correct for past-tense -ed still would not know whether errors were related to nonuse of -ed where required or to use of -ed on irregular past tense verbs. The pronoun error analysis format in Table 7.14 offers guidance for analysis with other forms. After calculating percentage correct, an SLP can attempt to describe the child’s stage of language development as outlined in Table 7.13. This process is not an exact science. Rarely is the determination clear-cut or is one and only one stage identified. Morphological markers are applied to word classes. For example, the past tense marker -ed is confined to verbs. Therefore, an SLP should also note word classes in which errors occur. Occasionally, errors are confined to only one word class, such as verbs. Nouns would be affected by such markers as plural regular and irregular, possessive, and articles. Verb markers include third-person singular, past tense regular and irregular, present progressive, modals, do + verb, copula (am, are, is, was, were), and perfective (have + be + verb). Finally, adjective and adverb markers include, but are not limited to, comparative (-er) and superlative (-est) and adverbial -ly. Pronouns offer a special case of morphological analysis because of the complex nature of the underlying semantic and pragmatic functions. If the child’s strategy is “when in doubt, use the noun,”

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TABLE 7.12

Stage of Mastery

II

III

IV

V+

Communication Assessment

Brown’s Fourteen Morphemes and Age of Mastery

Morpheme

Example

Age Range of Mastery* (in months)

Present progressive -ing. (no auxiliary verb)

Mommy driving

19–28

In

Ball in cup

27–30

On

Doggie on sofa

27–30

Regular plural -s

Kitties eat my ice cream. Forms: /s/, /z/, and /lz/ Cats (/kæts/) Dogs (/d⊃gZ/) Classes (klæslz), wishes (/wlʃlz/)

24–33

Irregular past

Came, fell, broke, sat, went

25–46

Possessive ’s

Mommy’s balloon broke. Forms: /s/, /z/, and /lz/ as in regular plural

26–40

Uncontractible copula (verb to be as main verb)

He is. (response to “Who’s sick?”)

27–39

Articles

I see a kitty. I throw the ball to daddy.

28–46

Regular past -ed

Mommy pulled the wagon. Forms: /d/, /t/, and /Id/ Pulled (/pυld/) Walked (/w⊃kt/) Gilded (/g l al d ld/)

26–48

Regular third person -s

Kathy hits. Forms: /s/, /z/, and /lz/ as is regular plural

26–46

Irregular third person

Does, has

28–50

Uncontractible auxiliary

He is. (response to “Who’s wearing your hat?”)

29–48

Contractible copula

Man’s big. Man is big.

29–49

Contractible auxiliary

Daddy’s drinking juice. Daddy is drinking juice.

30–50

*Used correctly 90% of the time in obligatory contexts. Source: Adapted from R. Brown (1973); J. Miller (1981).

Chapter 7

TABLE 7.13

Analyzing a Language Sample at the Utterance Level

199

Calculating Percentage Correct for Plural

Utterance

Correct

2. Want more cookies.

Incorrect

x

3. Three cookie. 4. No, one big cookies. 22. Dogs.

x

27. Give the pencils to me.

x

28. I want two pencils.

x

31. You color the foots. 48. What blue crayons?

x

TOTAL

5

Percentage correct =

Type of Error

Totalof correct Totalof correct +incorrect

x

Omitted

x

Placed on singular

x

Placed on irregular

3 =

5 8

= 62.5%

then it will be difficult to find errors in pronoun substitution (Haas & Owens, 1985). More in-depth analysis is required, possibly similar to that presented in Table 7.14. The types of errors made may reveal the underlying rules that the child is using. When analyzing the oral and written language of school-age children and adolescents, an SLP will want to note the scope of prefix and suffix use. In addition to inflectional suffixes, such as plural -s and past-tense -ed, derivational suffixes also should be analyzed. These suffixes, more common in written than in oral language, are used to change word classes, as in adding -er to a verb such as teach to create the noun teacher. The two most common derivational changes are from verbs to nouns (paint to painter) and from verbs to adjectives (run to runny) (Scott, 1984, 1988b). Children with CLD Backgrounds An SLP should be mindful of dialectal and bilingual variations. Even though a child omits a morphological ending, it cannot be assumed that the child does not understand or is not able to produce the morpheme. For example, children who speak African American English may omit some word endings for phonological reasons. Others are omitted because they are redundant, such as the plural -s when the noun is preceded by a number as in ten cent. The child’s abilities must be established by the testing of both the marker and the concept associated with it. The standard for comparison of children’s performance is the communication community of each child. A child’s language is impaired to the extent that he or she is unable to communicate effectively in that community. Two errors that occur in language assessment are (a) mistaking dialectal variations for disorders and (b) overlooking disorders mistakenly assumed to be dialectal variations. In general, dialectal variations develop by age 5, with a few noticeable at age 3 (Battle, 1990). Language sampling analysis of bilingual Spanish-English children should consider code switching, dialectal differences, English proficiency, and the effects of context on a child’s language performance (Gutierrez-Clellen, Restrepo, Bedore, Peña, & Anderson, 2000).

TABLE 7.14

Possible Pronoun Analysis Method Sub-analysis of Incorrect Responses

I me

III (MLU: 2.5–3.0)

IV (MLU: 3.0–3.75)

V (MLU: 3.75–4.5)

Post V (MLU: 4.5+)

Incorrect

Total

Percent Correct

Number

I (MLU: 1.0–2.0) II (MLU: 2.0–2.5)

Correct

Person

Pronoun

Gender

Stage

Case

Substitution

Omission

Ambiguous Reference

Overuse of Nominal

my it (subj.) it (obj.) you (subj.) your she them he we her (poss.) his him you (obj.) us they our its myself yourself her (obj.) their herself himself ourselves themselves TOTAL

Comments: Note: Pronouns, arranged by stage of acquisition, are scored as correct or incorrect, although the total and percent columns are initially left blank. Incorrect pronoun use is then analyzed as a substitution or omission error. Substitution may be multiple, as when she is used for his, demonstrating substitutions of case and gender. When this step is completed, the sample is checked to ensure that the referent has been clearly identified for each pronoun and that the child has not overused the referent name in place of a pronoun. These are also errors, and once noted, they should be added to the incorrect total on the left. When this step is completed, the total and percent correct columns can be completed.

Chapter 7

TABLE 7.15

Analyzing a Language Sample at the Utterance Level

201

Frequent Morphological Errors of Speakers with LEP

Morpheme

Type of Error

Possible Explanation

Articles

Omission or overgeneralization of the

Articles are used infrequently in many languages.

Auxiliaries and modals

Omission

Many languages do not have auxiliary verbs and rely on verb markers.

Contractions

Omission

Unstressed forms often omitted; a phonological error.

Copula

Omission

Unstressed forms often omitted.

Gerund

Omission of -ing ending

Many languages do not have this form.

Plural -s

Omission or error in agreement, as in many tree

Unstressed forms often omitted; used when other languages mark by adjective.

Possessive -’s

Omission or overgeneralization

Many languages use the possession of possessor form.

Prepositions

Substitution errors

Very complex system in English; multiple meanings of words.

Pronouns

Substitution errors, nounpronoun agreement errors

Most languages do not have as many pronouns as English.

Regular past -ed

Omission or overgeneralization

Unstressed forms often omitted.

Third-person -s

Omission or overgeneralization

Exception to English rule of no person or number markers.

The most frequent morphological errors of speakers with LEP are presented in Table 7.15. Morphological markers often are omitted or overgeneralized. Some Spanish speakers lump English syllables together, decreasing intelligibility. A Cuban American friend calls me “Bobowens.” This chunking may cause small units such as morphemes to be deemphasized or omitted. Syntactic Analysis Analysis also is accomplished at the intraclausal and clausal levels. For this type of analysis, it is best to exclude imitations, short answers to questions, and stereotypic or rote responses because these types of utterances are not usually clinically significant. For analysis purposes, it is helpful to separate sentences and nonsentences. Sentences are grouped as declarative, negative declarative, imperative, negative imperative, interrogative, and negative interrogative. Sentences can be grouped for further analysis by length or structure. For example, declarative sentences can be categorized as subject-verb, subject-verb-object, subject-verb-complement, and multiple clauses, either embedded or conjoined. The form of a preschool child’s sentences can be compared with normative data, such as those in Table 7.16, to best determine the child’s stage of development, although descriptive data are also valuable. The SLP should note intrasentential noun and verb phrase development, sentence types, and embedding and conjoining. These and other sentence analyses are especially important for school-age children and adolescents.

TABLE 7.16

Preschool Language Development and Brown’s Stages

Stage

Early I (MLU 1–1.5)

Approximate Age

12–21 mos.

Sentence Types

Intrasentential/Morphology

Single words. Yes/no questions use rising intonation. What and where. Negative + X. Semantic word-order rules.

Pronouns I & mine. Isolated nouns elaborated as art./adj. + noun. Serial naming without and.

Late I (MLU 1.5–2.0)

21–26 mos.

S + V + O appears. Negative no and not used interchangeably. Yes/no question form is This/that + X?

And appears. In & on appear.

Early II (MLU 2.0–2.25)

27–28 mos.

Wh- question form is What/where + noun? To be appears as main verb.*

Present progressive (-ing), no aux. verb mastered by 90%. Pronouns me, my & it, this & that. Nouns elaborated in object position only [(art./adj./dem./poss.) + noun].

Late II (MLU 2.25–2.5)

28–29 mos.

In/on & plural -s mastered by 90%.

Early III (MLU 2.5–2.75)

30–32 mos.

Basic SVO used by most. Negative element (no, not, don’t, can’t interchangeable) placed between noun and verb. What/where + N + V? Inversion in What/where + be + N?* S + aux. verb + V + O appears. Aux. verbs include can, do, have, will.

Gonna, wanna, gotta, hafta appear. Pronouns she, he, her, we, you, your, yours, & them. Noun elaboration in the subject & object position [art. + (modifier) + noun]. Modifiers include a lot, some & two. Select irregular past (came, fell, broke, sat, went) & possessive (-’s) mastered by 90%.

Late III (MLU 2.75–3.0)

33–34 mos.

S + aux. verb + be + X appears. Negative won’t appears. Aux. verbs appear in interrogatives: inverted with subject in yes/no type.

But, so, or, & if appear.

Early IV (MLU 3.0–3.5)

35–39 mos.

Negative appears with aux. verb + not (cannot, do not). Inversion of aux. verb and subject in Wh- questions.

Uncontractible copula (verb to be as main verb) mastered by 90%. Pronouns his, him, hers, us, & they. Noun phrase elaboration includes art./dem. + adj/poss./mod. + noun. Clausal conjoining with and appears. Clausal embedding as object with think, guess, show, remember, etc.

Late IV (MLU 3.5–3.75)

39–42 mos.

Double aux. verbs in declaratives. Add isn’t, aren’t, doesn’t, and didn’t. Inversion of be and subj. in yes/no interrogatives. Add when and how interrogatives.

Articles (the, a), regular past (-ed), & third person regular (-s) mastered by 90%. Infinitive phrases appear at end of sentence.

Stage V (MLU 3.75–4.5)

42–56 mos.

Indirect objects appear in declaratives. Add wasn’t, wouldn’t, couldn’t, shouldn’t. Negative appears with other forms of be. Some simple tag questions appear.

Pronouns our, ours, its, their, theirs, myself, & yourself. Relative clauses appear attached to object. Infinitive phrases with same subj. as main verb.

Post-V (MLU 4.5+)

56+ mos.

Add indefinite negatives (nobody, no one, nothing), creating double negatives. Why appears in more-than-one-word interrogatives. Negative interrogatives after 60 mos.

Irregular past (does, has), uncontractible auxiliary to be and contractible auxiliary to be and copula (to be as main verb) mastered by 90%. Remaining reflexive pronouns added. Multiple embedding; embedding + conjoining. Relative clauses attached to subj. appear.

*Copula

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The SLP can use Table 7.16 in a comparative fashion. For example, let us assume that a child said, “I want a big doggie.” The noun doggie has been expanded by the addition of an article and an adjective. This noun phrase occurs in the object position of the sentence. Expansion of the noun phrase in the object position is an example of structure occurring at Stage II and above, according to the intrasentential column of Table 7.16. The verb is unelaborated, as is the subject noun. These represent structures at the Stage I level or above. No further analysis is needed for sentence type. The child with LEP may not exhibit difficulty in a sentence-by-sentence analysis. Analysis of connected speech beyond the sentence may provide more insight. Word-order errors and cohesive difficulties become evident in analysis of units larger than the individual sentence. Noun Phrase Noun phrase elaboration is assessed by describing the number and variety of noun phrase elements. Analysis of noun phrases is especially appropriate for children in late childhood or adolescence. The order of the elements within the noun phrase is relatively fixed, although the order of development is not. The noun function is obligatory, and the other modifiers are nonobligatory. Some or all of these elements may be present in the noun phrase, as shown in Table 7.17. Some elements may be used in combination, whereas the use of others is more exclusive. Initiators consist of a small core of words that limit or quantify the phrase that follows. Examples are only, a few of, and merely. Most of these words can serve also as adverbs. The SLP must be careful to identify the accompanying noun phrase in order to avoid adverb-initiator confusion. Determiners come in many varieties and include, in order of mention, quantifiers; articles, possessive pronouns, and demonstratives; and numerical terms, such as two, twenty, or one hundred. Quantifiers include such words as all, both, half, twice, and triple. In combination with initiators, determiners can yield nearly all, at least half, and less than one-third. Articles include common forms such as the, a, and an. Possessive pronouns include my, your, and their and are used without articles. Demonstratives serve as articles but are interpreted from the perspective of the speaker as in this, that, these, and those. Adjectivals consist of nouns marking possession, as in mommy’s; ordinals, such as first, next, and final; adjectives, such as little, big, and blond; and nouns used as descriptors, as in hot dog stand and cowboy hat. Thus, a speaker might say, “Brother’s first little cowboy hat.” The exact order of adjectivals in a noun phrase is more complex, requiring more explanation than space allows; however, most speakers recognize that Cowboy little first brother’s hat is incorrect. The noun function can be filled by subjective pronouns, such as I, you, and they; objective pronouns, such as me, you, and them; genitive pronouns, such as mine, yours, and theirs; simple singular and plural nouns, such as boy, girls, and women; and mass nouns that have no distinction between singular and plural, as in sand, water, and police. When a pronoun is used, the noun to which it refers usually has already been identified, and the noun phrase is relatively simple. The noun function also may be complex or may consist of a phrase, as in Statue of Liberty, need to succeed, and city of Los Angeles, or a compound, as in Jim and Bob and duty and responsibility. Finally, if the noun is understood by both the speaker and the listener, it may be omitted, as in the following exchange: “What did you and Barb do last night?”“(We) Went to that movie at the mall.” Post-noun modifiers may take many forms, including prepositional phrases (in the gray flannel suit), embedded clauses (who lives next door), adjectivals (next door and driven by my mother), and adverbs (here and there). Post-noun modifiers may be used singly or in combination—for example, “The man who lives in the green house on the next block bought all of the candy that I was selling.”

TABLE 7.17

Elements of the Noun Phrase

Initiator

+Determiner

+ Adjectival

+ Noun

+ Post-Noun Modifier

Only, a few of, just, at least, less than, nearly, especially, partially, even, merely, almost

Quantifier: All, both, half, no, onetenth, some, any either, twice, triple Article: The, a, an Possessive: My, your, his, her, its, our, your, their Demonstrative: This, that, these, those Numerical Term: One, two, thirty, one thousand

Possessive Noun: Mommy’s, children’s Ordinal: First, next, next to last, last, final, second Adjective: Blue, big, little, fat, old, fast, circular, challenging Descriptor: Shopping (center), baseball (game), hot dog (stand)

Pronoun: I, you, he, she, it, we, you, they, mine, yours, his, hers, its, ours, theirs Noun: Boys, dog, feet, sheep, men and women, city of New York, Port of Chicago, leap of faith, matter of conscience

Prepositional Phrase: On the car, in the box, in the gray flannel suit Adjectival: Next door, pictured by Renoir, eaten by Martians, loved by her friends Adverb: Here, there (embedded) Clause: Who went with you, that you saw

Examples Nearly . . . . . . . . . . . . . . . . . . all the one hundred . . . . . . . . . . . . . . . . . old college . . . . . . . . . . . . . . . . . . . alumni . . . . . . . . . . . . . . . . . . . . . attending the event Almost all of . . . . . . . . . . . . her thirty . . . . . . . . . . . . . . . . former . . . . . . . . . . . . . . . . . . . . . . . clients Just . . . . . . . . . . . . . . . . . . . . half of your . . . . . . . . . . . . . . brother’s old baseball . . . . . . . . . . . . . . . . . . uniforms . . . . . . . . . . . . . . . . . . . in the closet

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The development of elements of the noun phrase takes most typically developing children many years and continues into adolescence. As noted in Table 7.16, elaboration begins in isolation and then moves to the object position in the sentence before appearing in the subject position. This pattern is only the beginning of the development process; with increasing age, the child should use more and more noun elaborations. Adjectives and determiners appear at the two-word stage for both children with LI and those without. Initiators and post-noun modifiers appear later, with children with LI exhibiting a marked delay. For children developing typically, clausal post-noun modifiers appear in late Stage IV and V (See Table 7.16). Most 5-year-olds use no more than one modifier with each noun. Thus, most internal development of the noun phrase occurs in later childhood and adolescence. Both elaborated pre-noun and post-noun modification, using relative clauses and prepositional phrases, develop during this period (Nippold, 1993; Perera, 1986a, 1986b; Scott, 1988a, 1988b). The most elaborated forms usually are produced in written language. An SLP is interested in the distribution of these elaborations in these positions and the average number of morphemes within noun phrases. It may be helpful for an SLP to use a format of analysis similar to that in Table 7.17. Children with LI can be expected to have simpler, less elaborated noun phrases. Pronouns offer a special problem. Children with LEP may exhibit confusion with modifier order and pronoun use. Verb Phrase As mentioned in Chapter 2, verb morphology is particularly difficult for children with SLI. Analysis of verb phrase construction and inflected morphology can be a useful measure for identifying 31⁄2- to 6-year-olds with SLI (Bedore & Leonard, 1998). Verb phrase elaboration consists of the verb and associated words, including noun phrases used as complements or as direct or indirect objects. An SLP is concerned with the verbs used and those that are missing or incomplete. Other elements of the verb phrase that are present or absent are also important and reflect the maturity of the speaker’s language system. Predicate or verb relationships take three forms: intransitive, in which the verb cannot take an object as in she walks; transitive, in which the verb can take an object as in to her; and equative, which consists of the copula (to be) plus a complement of a noun, adjective, or adverb as in they are students, they are young, or they are late respectively. Verb phrases can be described by the length and range of types, as demonstrated in Table 7.18. Simple transitive (Mommy throw) and equative verb phrases (Doggie big) appear at an MLU of about 1.5 (Kamhi & Nelson, 1988). At this stage, the verbs are unmarked for tense or person, and the copula is omitted. As language becomes more complex, verbs become marked, the copula appears, and intransitive verb phrases appear. By Stage II, the progressive -ing marker and catenatives (gonna, wanna, gotta, hafta) appear. The perfective form (have + verb-en) and the passive voice begin to be used by Stage IV. Adverbial phrases also appear in Stage IV. Late childhood and adolescent language development is characterized by increasing verb complexity with the use of auxiliaries, (do, have) modals (may, should), and perfective forms, such as have been going. There is also increasing use of adverbs and adverbial phrases, such as prepositional phrases of manner (in silence), place (in the city), and time (in a week) (Scott, 1984). In general, even children with LI who exhibit these more complex structures tend to use them less frequently than do children developing typically. Tense markers are used to describe the temporal relationships between events. For example, if the event being described is taking place while the speaker mentions it, the speaker uses the present progressive verb form (auxiliary + verb-ing) to indicate an ongoing activity (walking, eating). In contrast,

Chapter 7

TABLE 7.18

Analyzing a Language Sample at the Utterance Level

207

Elements of the Verb Phrase

Modal Auxiliary

+Perfective Auxiliary

May, can, shall, will, must, might, should, would, could

Have, has, had

+ Verb to be

+ Negative*

+ Passive

+ Verb

Am, is, are, was, were, be, been

Not

Been, being

Run, walk, eat, throw, see, write

+ Prepositional Phrase, Noun Phrase, Noun Complement, Adverbial Phrase

On the floor, the ball, our old friend, a doctor, on time, late

Examples: Transitive (May have direct object) May . . . . . . . . . . . have . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . wanted. . . . . . a cookie Should . . . . . . . . not . . . . . . . . . . . . . . . . . . . . . . . . throw . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . the ball in the house Intransitive (Does not take direct object) Might . . . . . . . . . . have . . . . . . . . been . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . walking . . . . . to the inn Could . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . not . . . . . . . . . . . . . . . . . . . . . . . talk . . . . . . . . with you Equative (Verb to be as main verb) . . . . . . . . . . . . . . . . . . . . . . . is . . . . . . . . . . . . not . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . a doctor . . . . . . . . . . . . . . . . . . . . . . . was . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . late . . . . . . . . . . . . . . . . . . . . . . . were . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . on the sofa May . . . . . . . . . . . . . . . . . . . . . . . . be . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . ill * When model auxiliaries are used, the negative is placed between the model and other auxiliary forms, for example, “Might not have been going.”

the perfect form of the verb (have + verb-en) indicates that the action is being described in relation to the present. Thus, “I have been working here for two years” implies that this action is still occurring, whereas “I have eaten my dinner” implies that the action is now complete. Verb tense analysis can be accomplished in a form similar to that presented in Table 7.18. Table 7.16 identifies the ages at which most preschool children acquire auxiliary and modal auxiliary verbs. Irregular past tense verbs are a special problem (Shipley, Maddox, & Driver, 1991). English contains approximately 200 irregular verbs. Although many are used infrequently, words such as went, saw, sat, and ate, are among the most frequently used verbs. Development begins in the preschool years and extends into adolescence. Their irregular nature precludes rule learning and generalization, and most acquisition is by rote (Shipley & Banis, 1989). Some morphophonemic regularities do occur, however, and may influence the relative ease of learning (Shipley et al., 1991). The least difficult verbs to learn are those that exhibit no change from present to past, such as cut/cut and hurt/hurt. The most difficult seem to be those with a final consonant change from /d/ to /t/, as in build/built (Shipley et al., 1991). Other morphophonemic changes include internal vowel change (fall/fell, come/came), vowel

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change with added final consonant (sweep/swept), total change (go/went), and vowel change with a final dental consonant (ride/rode, stand/stood). Obviously, other factors, such as the concept expressed (semantics) and the sounds involved (phonology), also affect learning. Table 7.19 presents the ages at which 80 percent of children are able to use different irregular verbs in a sentence completion task. In addition to manner and result, adverbs, like verbs, also mark temporal relations. Temporal relations can be expressed between two events (before, next, during, meanwhile), with the continuation of an event (for the past year, all week), in the recent past (recently, just a minute ago), and with repetition (many times, again). Verb aspect indicates temporal notions, such as momentary actions, duration, and repetition. Momentary actions are of short duration (fall, break, hit). In contrast, duration is marked by verbs of longer action with definite beginnings and ends (sleep, build, make). Phrases also may be used to convey a definite act (sing a song) and an act without a well-defined terminal point (sing for your own enjoyment). Still other verbs describe repetitive actions (tap, knock, hammer). All these characteristics affect verb learning. The development of tense markers seems to be related to the temporal aspect of each verb. The SLP should investigate the relationship between tenses the child uses and the verbs to which these tenses are applied. No doubt, a full analysis will require something larger than a 50- to 100-utterance sample. Modal auxiliary verbs, such as can, could, will, should, shall, may, might, and must, are used to express the speaker’s attitude (Bliss, 1987). Syntactically, modals function in the formation of questions (Can we go tonight?) and negatives (I shouldn’t go out in this weather.) They are used also in such statements as “I will do it tomorrow.” As with the pronoun system, modals represent a complex interaction of form, content, and use that is reflected in the slow rate of acquisition, which usually lasts from age 2 to age 8. Semantic categories of modals include wish or intention (will, would), necessity or obligation (must, should), ability or permission (can), certainty (will), and probability or possibility (may, might) (Bliss, 1987).

TABLE 7.19

Irregular Verbs and Age of Acquisition

Age in Years

Irregular Verbs

3:0 to 3:5 3:6 to 3:11 4:0 to 4:5 4:6 to 4:11 5:0 to 5:5 5:6 to 5:11 6:0 to 6:5 6:6 to 6:11 7:0 to 7:5 7:6 to 7:11 8:0 to 8:5 8:6 to 8:11

Hit, hurt Went Saw Ate, gave Broke, fell, found, took Came, made, sat, threw Bit, cut, drove, fed, flew, ran, wore, wrote Blew, read, rode, shot Drank Drew, dug, hid, rang, slept, swam Caught, hung, left, slid Built, sent, shook

Source: Adapted from Shipley, Maddox, & Driver (1991).

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Those modals associated with action, such as can and will (ability, intention, and permission request), are acquired first. During the third year, the number of modals and the categories increases. After age 4, the child clarifies the different forms and their uses. Children with LI rarely use modal auxiliaries, possibly because they lack the linguistic subtleties expressed. In general, children with LI have more difficulty with catenatives (gonna, wanna), modals, and auxiliary verbs than their language level would suggest. An SLP is interested in the range and frequency of the types of verbs a child exhibits. Children with CLD backgrounds may experience difficulty with verb tense and with auxiliary verbs. Irregular past tense verbs may exhibit substitutions (I go yesterday.) Verb endings may be omitted as a general phonological rule pattern. Verb-subject agreement is also difficult (She go every day). When analyzing a sample, an SLP pays particular attention to the level of development, the range of semantic concepts, the variety of usage, and the types of errors (Bliss, 1987). Variety of usage is noted with different pronouns, verb tenses, negative and positive statements, and sentence types. Sentence Types A single event may be described by the agent that originates the action, the action or state changes, and/or the recipient or object of that action (Duchan, 1986b). In English, the agent as a noun or a noun phrase is usually first, followed by the action word or verb, which in turn is followed by the recipient or object of that action in the form of a noun or a noun phrase (“John threw the ball” or “Mother will eat the cookie”). If the agent performs the action for the benefit of some other person, that beneficiary—the indirect object—either precedes or follows the noun phrase describing the object of the action. For example, in “He painted the picture for mother,” for mother follows the object of the sentence. Likewise, we could say, “He painted mother a picture.” Instruments used to complete the action usually are placed after the action and follow the preposition with, as in “He painted with a brush.” Sentences that differ from the predominant subject-verb-object English format may be difficult for the child with LI to decipher and form. Often, overreliance on the S-V-O strategy is not noted until the child begins school. The child with LI may resist rearrangement or interruption of this form and may attach other structures only at the beginning or the end. Yes/no questions may be asked with rising intonation, rather than through transformation of the subject and verb elements (He is sick? vs. Is he sick?) Passive sentences, which use an object-action-agent form, may be misinterpreted. An SLP is interested in the range of internal sentence forms and in the different sentence types. Sentence types include positive and negative forms of the declarative, interrogative, and imperative. Declarative sentences are statements (“He likes ice cream” or “She does not want to go”). Interrogatives include three types of questions, including yes/no, wh- or constituent, and tag. The form of yes/no questions may vary from a statement with rising intonation (“You went to the store?”) to a subject-verb reversal using the copula or an auxiliary verb (“Is he happy?” or “Did she eat her pie?”). Wh- questions begin with such words as what, where, who, why, when, and how. Either the copula or auxiliary verb and the subject are reversed from their order in a statement (“What is her age?” or “Why did he go?”). A less mature form that can be used with some wh- questions places the whword at the end of the sentence (“She likes what?”) or does not reverse the subject and verb (“what he want?”) Tag questions are statements with question tags attached (“She’s lovely, isn’t she?”). These are the most difficult type.

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The preschool development of questions is given in Table 7.16. Mature tag questions, because of their complex nature and infrequent use in American English, are acquired much later than are yes/no and wh- interrogatives. Some children do not master the mature tag form until mid-elementary school (Reich, 1986). A less complex form using okay or all right (or the Canadian eh) may appear in preschool (“I do this, okay?”). The range of sentence types and the maturity of form are of interest. These are listed in Table 7.16. With more mature speakers, an SLP must consider the use of emphasis, pauses, and intonation to mark different meanings for the same form. Pauses mark the end of conceptual units and direct the listener in the type of response required. For example, “Do you like football (pause) or baseball?” requires a very different response (pick one) from “Do you like football or baseball?” (yes or no). Rising intonation is used on an entire word for unexpected or surprise events and falling intonation for the expected. As mentioned previously, rising intonation at the end of a word or a sentence also signifies a question, and falling intonation signifies a statement. Imperatives are commands (“Eat your dinner” or “Stop that”). The subject, you, is understood. SLPs must be careful not to confuse these sentence types with utterances in which a child omits the subject. The child who repeatedly omits the subject in other sentences probably should not be credited with imperative forms. The behavior of other people may be influenced also by requests. These are discussed in Chapter 5 and in the intentions section of this chapter because of the pragmatic aspects of this form. Negative sentences, whether declarative, interrogative, or imperative, also possess characteristic developmental forms (Table 7.16). The child’s first negatives are marked by no and slightly later by not. Initially, these two forms are used interchangeably. To these are added don’t and can’t, also used interchangeably, followed by won’t. Positive forms of do, can, will, and would develop later, followed by negative forms for the verb to be and for other auxiliaries. By school age, a child develops indefinite forms (e.g., no one, nothing) and indirect negative imperatives (“Watch out for the hole”). During the schoolage years, the child masters such negative prefixes as un-, non-, and ir-. Embedding and Conjoining Both embedding and conjoining involve relationships between clauses. In addition, embedding involves the relationships between phrases and clauses. A clause consists of a noun phrase and a verb phrase. A clause that can stand alone is an independent clause, or sentence, even though it contains only the noun and the verb (“John ran”). Some clauses contain both elements but are not independent. These clauses, such as “that you want,” must be attached to an independent clause or sentence in a process called embedding. In this manner, “that you want” can be embedded in “The toy is on sale” to form “The toy that you want is on sale.” Two or more independent clauses can be joined together by a conjunction, such as and or but, in a process called conjoining. It’s sometimes difficult for students to identify multiclausal sentences as conjoined or embedded. I suggest that you refer to the excellent tutorial by Steffani (2007). Her descriptions and identification flowchart are presented in Table 7.20 and Figure 7.1 respectively. Clausal embedding initially develops in the object position at the end of the sentence (Table 7.16). Called object noun complements, these dependent clauses take the place of the object following such words as know, think, and feel (“I know that you can do it”). Object noun complements using that (“I think that I like it ”) appear at an MLU of 4.0, most frequently following the verb think (Tyack & Gottsleben, 1986). By an MLU of 5.0–5.9, this type of embedding accounts for only 6 percent of chil-

Chapter 7

TABLE 7.20

Analyzing a Language Sample at the Utterance Level

211

Complex Sentence Descriptions and Examples

Description

Examples

1. Full propositional complement (Object noun phrase complement): Contains a “cognitive” verb such as think, guess, wish, know, hope, wonder, show, remember, pretend, mean, forget, say, tell; may or may not contain that

I hope (that) we go to lunch soon. Forget that you did it.

2. Gerund: Contains an -ing form that functions as a noun (is not directly related to the auxiliary verb)

Swimming is fun. I felt like jumping.

3. Participle: Contains an -ing form that functions as an adjective (modifies a noun or pronoun) (is not directly related to the auxiliary verb)

I see the man driving down the street. I want the dog barking loudly.

4. Simple infinitive: Contains to followed by a verb; subject is the same as the main sentences; this does not include early developing catenatives such as gonna, wanna, gotta, sposta, hafta, let’s, lemme

I need to go. They want to sleep in the tent.

5. Infinitive clause with different subject: Contains an infinitive (to + verb); the subject of the infinitive clause is different from the main clause

I want the baby to eat. He needs the dog to go away.

6. Unmarked infinitive: Contains make, help, watch, or let without a to marker

Watch me run. Let me do it.

7. Simple wh- clause: Contains who, what, where, when, why, how ; does not contain an infinitive to marker

See how fast I am. I remember what we do.

8. Wh- infinitive: Contains a wh- word (what, where, who, how, when) and an infinitive

I don’t know what to wear. You know where to put it?

9. Relative clause: Contains an embedded phrase that functions as an adjective; modifies an object or subject noun phrase; may be marked by who, which, that

The man who is running is fast. That is the one that I like.

10. Simple conjoining: Contains two clauses that are joined by a conjunction; can be coordination (and, but, or, etc.) or subordination (because, after, etc.)

I ate fast so I could leave.

11. Embedded and conjoined: Contains both an embedded and conjoined clause; may include a catenative; will have 3 or more verbs

I like cake and I like ice cream.

Swimming is fun because I like to get wet. I want to stay here, but my mommy says no.

dren’s two-clause sentences. Object noun complements using what (“I know what you did”) account for 8 percent of these sentences. Relative clauses attached to nouns develop next, beginning in the object position, as in “I want the dog that I saw last night.” Finally, the relative clause moves to the center of the sentence, describing the subject, as in “The one that you ate was my favorite.” During late childhood and adolescence, an increase occurs in relative clauses either attached to the subject or serving as the subject, as in “Whoever wishes

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COMPLEX SENTENCES Look through the language sample/narrative and mark all the sentences that: Have 2 or more MAIN verbs NOTE: catenatives (gonna, wanna, gotta, etc.) are counted ONLY if there are 2 other verbs

WH INFINITIVE

YES

is it preceded by a whword?

YES How many THREE Is there a * verbs? conjunction? or MORE NO TWO YES is there an infinitive verb (to+verb)?

NO SIMPLE INFINITIVE

ONE

How many subjects? TWO

CONJOINED AND EMBEDDED

MULTIPLE EMBEDDED

NO is there make, help, YES watch, or let without an infinitive to marker?

UNMARKED INFINITIVE

NO INFINITIVE CLAUSE WITH DIFFERENT SUBJECT

FPC ***

is there a conjunction (e.g., and, or, but, so, because, after)?

YES

SIMPLE CONJOINING

YES

SIMPLE WH- CLAUSE

is it preceded by a NO cognitive verb: YES e.g., think, wish, guess, YES is there/could there be know, hope, wonder, the word that? ** show, mean, remember, pretend, forget, say, tell? NO NO RELATIVE CLAUSE

is there the word why, where, when, or how? NO

YES

YES is there what, is it functioning as an adjective? who, which? NO NO SIMPLE WH- CLAUSE

YES is there a verb+ing (e.g., running, jumping)? NO

*

** ***

Words that connect two complete sentences such as: and, or, but, so, which, because, while, if, after, before, though, although, whether, as, since, except, therefore. Example: Remember (that) you are big. Full Propositional (or Object NP) Complement

are you still looking for an answer? YES SOMETHING IS WRONG! START AGAIN.

is it connected to an auxiliary YES verb (is, am, are, was, were)?

OOPS— try again

NO is it functioning NO as an adjective?

GERUND

YES PARTICIPLE

FIGURE 7.1 Flowchart to aid in identifying conjoined and embedded complex sentences. Source: Steffani (2007). Identifying embedded and conjoined complex sentences: Making it simple. Contemporary Issues in Communication Science and Disorders, 34, 44–45. Reprinted with permission.

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to go should come to the office.” This type of clausal embedding is more common in written language than in oral (Perera, 1986a, 1986b; Scott, 1988a, 1988b). Relative clauses appear less frequently among preschoolers than other forms of clausal embedding, although by school age, 20 to 30 percent of two-clause sentences may be of this type. Relative clauses appear at about 48 months initially as post-noun modifiers for empty nouns, such as one or thing (Wells, 1985). The most common relative pronouns for preschoolers are that and what. During the school years, relative pronouns expand with the addition of whose, whom, and in which. Phrases also may be embedded in clauses. As in clausal embedding, phrasal embedding usually develops initially at the end of the sentence. A phrase is a group of related words that does not contain a subject and a verb and are of several types, including prepositional, participial, infinitive, and gerund phrases. Such phrases take the place of nouns or modify nouns. Prepositional phrases also may be adverbial in nature, as in “She will arrive in a minute.” During late childhood and adolescence, an increase occurs in both the number and length of adverbial phrases (Scott et al., 1992). Infinitive phrases first appear in the object position, most frequently following want (“I want drink pop”). This form with the to omitted emerges at a median age of 30 months (Wells, 1985). Infinitives with a different subject from the main verb (“Mommy, I want you to eat it”) appear somewhat later. An SLP is interested in the number and type of embeddings. Some developmental data are included in Table 7.16. The position of these embeddings within the sentence is also important, given the developmental significance of position. Clausal conjoining appears relatively late in preschool development, although some conjunctions appear much earlier. Usually, and is the first conjunction learned; it is used to join objects in a group. Throughout the preschool period, and continues to be the most frequently used conjunction, being five to twenty times more common than but (Scott, 1988a). Around 30 months of age, children begin to sequence clauses, using and as the initial word in each sentence (“And we saw ponies”). As noted in Table 7.16, and is also the first conjunction used to join clauses. At this point, and is used for sequential events and is interpreted as and then. Even among school-age children, 50 to 80 percent of all narrative sentences begin with and (Scott, 1987). With age and an increase in written communication, use of and decreases. Between ages 11 and 14, only 20 percent of spoken narrative sentences begin with and. In written narratives, the rate is only about 5 percent (Scott, 1987). Other conjunctions may express a causal relationship (because), simultaneity (while), a contrasting relationship (but), and exclusion (except). Conjunctions generally develop in the following order: and, because, when, if, so, but, until, before, after, since, although, and as (Scott, 1987; Tyack & Gottsleben, 1986; Wells, 1985). The most frequently used conjunctions through age 12 are and, because, and when. Early developing strategies that rely on the order of mention for interpretation may persist with a child with LI. Thus, a child ignores the conjunctions and their intended meanings. The sentences “Go to the market before you go to the movie” and “Go to the market after you go to the movie” are interpreted as having the same meaning because of the order of the clauses. An SLP is interested in the range and frequency of the conjunctions used and in the amount of conjoining present in the sample. This information is especially important with more mature speakers and is discussed in the following chapter on narratives. An SLP also should note multiple embeddings and embedding and conjoining that occur within the same sentence. Again, this usage is much more characteristic of school-age language than of preschool language. The narratives of children ages 10 to 12 years are easily distinguishable from those of preschoolers by the presence of multiple embedding and conjoining within the same sentence (Perera, 1986a, 1986b; Scott, 1988a, 1988b).

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Computer-Assisted Language Analysis Several computer-assisted language analysis (CLA) methods are available, each based on some particular model of language structure. CLAs provide the SLP with a quick, efficient, standard analysis routine. Most CLA formats have three common features (Long, 1991). First, all utterances must be coded to assist the computer in identifying structures. This time-consuming step may be shortened for an SLP by having an assistant make an initial transcription (J. Miller, Freiberg, Rolland, & Reeves, 1992). This transcription can be corrected and readied for analysis by the SLP. Second, the computer recognizes, analyses, and tabulates the identified structures from the transcript. Third, the program displays the results in an interpretable format. A list of available CLA syntactic and phonological software is provided in Table 7.21.

TABLE 7.21

Computer-Assisted Language Sample Analysis Software

Software

Description

Syntax/Morphology

Automated LARSP (Bishop, 1985)

Based on Language Assessment Remediation and Sampling

Computerized Language Analysis (CLAN) (MacWhinney, 2000)

Designed to analyze data transcribed in the Child Language Data Exchange System (CHILDES). Free software can be downloaded. Includes frequency counts, word searches, co-occurrence analysis, MLU counts, interactional anlysis, text changes, and morphosyntactic analysis. Based on Conversational Act Profile (Fey, 1986), Developmental Sentence Analysis (DSS) (L. Lee, 1974), Profile in SemanticsLexical (PRISM-L) (Crystal, 1982). Profile of Prosody (PROP) (Crystal, 1982), Profile of Phonology (PROPH), (Crystal, 1982). Calculates MLU and type-token ratio Uncoded transcript

Computerized Profiling (Long & Fey, 1988, 1989)

DSS Computer Program (Hixson, 1983)

Based on Developmental Sentence Analysis (DSS) (L. Lee, 1974) Coded transcript.

Lingquest 1 (Mordecai, Palin, & Palmer, 1985)

Calculates MLU and type-token ratio Coded transcript

Parrot Easy Language Sample Calculates MLU Analysis (PELSA) (F. Weiner, 1988) Coded transcript Pye Analysis of Language (PAL) (Pye, 1987)

Flexible analysis categories Coded transcript

Systematic Analysis of Language Transcripts (SALT) (J. Miller & Chapman, 2003)

Based on Brown’s Stages of Development Flexible analysis categories Calculates MLU, NDW, TNW Coded transcript

Source: Adapted from Long (1991).

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Once mastered, CLA is more efficient than analysis by hand; this efficiency increases as the complexity of analysis increases (Long & Masterson, 1993). Although CLAs may quicken the analysis phase of sampling, they cannot replace the clinical intuition of the trained SLP. Nor can CLAs fill the deficiency caused by a poorly collected sample. In addition, only the SLP can use the data generated to make clinical decisions.

Conclusion The conversational sample is a rich source of data about children’s language. Within utterances both qualitative and quantitative measures are possible. Obviously, such analysis is time-consuming. SLPs should analyze only areas of suspected difficulty rather than attempt a blanket analysis. Of interest is the child’s present communication system and the communication characteristics of the child’s communication partners. Unlike the larger-unit analyses discussed in Chapter 6, within-utterance measures can be compared more readily to similar data from children developing typically.

8

chapter

Narrative Analysis

Chapter 8

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arratives are a self-initiated, self-controlled, decontextualized form of discourse. As such, narratives are an important part of the language assessment of older school-age children and adolescents because they provide an uninterrupted sample of language that the child or adolescent modifies to capture and hold the listener’s interest (Crais & Chapman, 1987; Hewitt & Duchan, 1995; Liles, 1985a, 1985b, 1987; Scott, 1988b). The narrative speaker is responsible for ordering and providing all of the information in an organized whole (F. Roth & Spekman, 1985). Although narration and conversation share many qualities, they differ in very significant ways. First, narratives are extended units of text. Second, events within narratives are linked with one another temporally or causally in predictable ways. Narratives are organized in a cohesive, predictable, rulegoverned manner representing temporal and causal patterns not found in conversation. Third, the speaker maintains a social monologue throughout. The speaker must produce language that is relevant to the overall narrative while remaining mindful of the information needed by the listener. Fourth, narratives have an agentive focus. In other words, narratives are about agents—people, animals, or imaginary characters—engaged in events over time. Narratives are not limited to fictional storytelling, thus narrative evaluation should not consist solely of a child or adolescent recounting fairy tales or formulating stories from pictures. Oral narration includes the telling of self-generated stories, storytelling of familiar tales, retelling of movies or television shows, and recounting of personal experiences. Most conversations include narratives of this latter type. How often we begin conversations with “You’ll never believe what happened to me coming to work today,” or “Let me tell you what it means to get into a hassle.” Diagnostically, narratives are good for eliciting a variety of complex syntactic structures (Gummersall & Strong, 1999). The narratives of children with LD and TBI are shorter and less mature and have less mature episode and sentence structure than those of age-matched TD peers (S. Chapman, 1997; Merritt & Liles, 1987, 1989; F. Roth & Spekman, 1986). Students with LD demonstrate knowledge and use of story elements but convey and recall less information. In addition, children with LD retrieve less information and make fewer inferences than do TD children. Although the stories of children with LD contain all of the elements in the generally appropriate order, they are substantially shorter and contain fewer and more poorly organized complete episodes (Liles, 1990). Episodes are also less likely to be related linguistically (F. Roth & Spekman, 1985). In addition, more statements of children with LI are not integrated into the episode structure (Liles, 1990). This paucity of information may reflect a lack of presuppositional skills (F. Roth, 1986). Possibly because of the communication demands placed on the child in narration, the narratives of children with LD exhibit a greater rate of communication breakdown (MacLachlan & Chapman, 1988). Although children with LD use conjunctions and unambiguous reference, they are less efficient in their use than TD peers (Liles, 1985a). In general, children with LD often fail to consider the needs of their audience (Liles, 1987). The internal story organization of children with LI is also less complete than that of age-matched TD peers (Merritt & Liles, 1987) and contain more statements that are not integrated into the episode structure. Usually, these children have difficulty describing and manipulating props and activities (Sleight & Prinz, 1985). Oral and written narratives should form a portion of any child’s language assessment. The results should be compared with a child’s other linguistic abilities prior to making judgments on the adequacy of the child’s language system.

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Scripts and Narrative Frames Narratives are an expression of the organization and interconnection of data in the brain. The storyteller must construct a context within which to relate events, both real and imaginary. Narratives consist of two frameworks, scripts and story frames (Naremore, 2001). Scripts consist of typical, predictable event sequences formed on the basis of experience, either real or vicarious. Scripts are not about any one experience but are generalized, organized hierarchically and causally, inhabited by characters, and contain a predictable sequence of events. Each event is represented in the brain and becomes part of a generalized event sequence, such as birthday parties. Narrative frames are mental models of story structures. We use them to facilitate production and comprehension of narratives. In short, narrative frames are mental organizers that reduce processing demands. The narratives of children with LI may break down because of linguistic difficulties or because they don’t know either the script or the narrative frame. If too much mental capacity is used for linguistic processing, the narrative frame and/or the script may collapse. In similar fashion, poor script knowledge or poorly formed narrative frames may require too much mental “energy,” leaving the child little capacity for linguistic processing. Prior to collecting a narrative, an SLP should attempt to determine if a child has script and narrative frame knowledge. Script knowledge can be assessed by inquiring about a child’s experiences, routines, and event knowledge (Naremore, 2001). Assessment of the retrieval of script knowledge can be accomplished by asking a child to act out the script with toys, pictures, or other items. If the child is successful, the SLP attempts to have the child recite an event account with a cue such as “Tell me what you do when you do X” or “Tell me what happened one time when you did X.” If the child needs more help, the SLP can ask a few questions to determine the setting, then begin as follows: You ride the bus to school every day. Last week on the way to school, you . . . Note that the focus is the child and the verb tense is present. The SLP can assist the child with the event recount by saying, “And then” or “Tell me what happened next.” The recount should have some logical organization. Knowledge of narrative frames can be determined by discussing with a child the purpose of narratives and determining the child’s experience with narrative frames, either at home or in school. The SLP is interested in the use of narratives at home and in story reading. Narrative frames will be analyzed in more detail after a few narratives have been collected. Children will not possess scripts for all possible events. Nor will all children possess narrative frames. Cultural variations are to be expected and will be discussed at the end of this chapter. The SLP should be reasonably positive that the child possesses event and script knowledge and a notion of narrative frames prior to beginning a narrative collection and analysis.

Collecting Narratives The quality of a narrative is influenced by the selection of appropriate stimuli and topics based on the age, verbal ability, interests, and gender of a child or adolescent (Hedberg & Stoel-Gammon, 1986). Stimuli may include objects or pictures used for original constructions and heard or read stories used

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for retelling. In general, the task used to elicit the narrative influences the speaker’s adaptation to the listener. There are many different types of stories and many different contexts within which to tell them. The story type and context affect the eventual narrative form produced (Scott, 1988b). In general, maximally naturalistic topics and contexts elicit the most representative narratives. Other variables that may affect the narrative form are the story type, a child’s experiential base, the task in which the narrative is told, the source of the narrative, the topic, the formal or informal atmosphere of the context, and the audiovisual support available (Scott, 1988b). Because the unit of analysis is the entire narrative, several oral and written narratives should be collected. The wide variation in narratives that can be produced by a single child within different contexts supports this notion. Prior to collecting, the SLP decides on the type of narratives desired and the stimuli to be used in their collection. In general, fictionalized narratives with a vicarious experiential base may result in incomplete narratives with little emphasis on goals, characters’ feelings or motivations, and endings. The pace, action orientation, and frequent commercial interruption found in television form a very different base for narratives than does experience or even traditional fables or fairy tales. The type of elicitation task will affect the child’s performance (Gibbons, Anderson, Smith, Field, & Fischer, 1986; Griffith, Ripich, & Dastoli, 1986). Books elicit descriptive information, whereas films elicit action sequences (Gibbons et al., 1986). Films also elicit more causal sequences in retelling than do oral stories. Pictures tend to constrain the form of the narrative and may lead to the production of additive chains (And this . . . and this . . .), although children with Down syndrome express more verbal content in narratives to wordless picture books than might be expected based on their formal test results (Miles & Chapman, 2002). Stories in response to pictures tend to exclude character information, internal responses, or intentions (Griffith et al., 1986). Shared information may be omitted and new information treated as old even when the listener has not viewed the picture. In contrast, individual photographs or discussions of familiar events foster event chains. Narrative retelling and recall can be used to determine a child’s memory organization (Lovett, Dennis, & Newman, 1986). In narrative retelling, the child listens to a well-formed story and then reconstructs the story orally or in writing. Retelling of short narratives even may serve as a screening tool with young elementary school children. At this age, children should be able to retell the story without deviating significantly from the original in sequence or content. In general, children with LI produce longer and more complete stories in retold narratives than in self-generated ones (Merritt & Liles, 1989). Clause length is also greater in retold narratives. Comprehension can be assessed within retold narratives by questioning a child when the original telling is complete. In general, children with LD perform much like younger children, recalling less of the stimulus story (Crais & Chapman, 1987). It is important to consider the amount of structure inherent in the stimulus and its effect on retold story construction. For example, nondescript dolls or puppets or sets of vehicles provide no structure. In contrast, a sequence of related pictures provides maximal structure. In general, the more structure found in the stimuli, the less structure the child must provide. The best stories, measured by the most complete episodes and the amount of information, occur when children retell a story without picture cues (Schneider, 1996). Although pictures provide additional input, thus reducing the memory load, they provide no linguistic structure in and of themselves. The task then becomes one of story generation rather than retelling. Pictures may distract some children with LI.

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In story retelling tasks, an SLP must consider the comprehension skills needed to understand the story, the mode of presentation (oral or written), story length, a child’s past experience with the story genre (e.g., fairy tale, mystery), the child’s interest in the content, and the degree of story structure (Hedberg & Stoel-Gammon, 1986). In general, more familiar, more interesting, and more structured stories result in more complete, better organized retellings. Well-formed stories should be chosen for retelling and should be modified to enhance clarity and organization (Gordon & Braun, 1985). Stories can be rewritten to reduce complexity in their oral form and to summarize important sections. Subparts and transitions between parts of the narrative may need to be highlighted. Good narrative models often have repetitive elements. Independent, self-generated narrative production requires a child to use her or his own organizational structure and narrative formulation. Narratives can be classified as fictional, personal-factual, or a combination of the two. Fictional or make-believe stories are good vehicles for preschoolers and may be stimulated by objects or pictures (F. Roth & Spekman, 1986; Westby, 1984, 1985). The SLP should provide a model narrative, begin the story for the child, or ask the child to relate a story about the object or picture, beginning with, “Once upon a time . . .” This initial structure usually results in a more literate style. Personal-factual narratives may be collected from conversation or prompted. This type of narrative is very common in preschool and early elementary school, especially in show-and-tell activities. Preschoolers naturally create these types of narratives in conversation with each other (Preece, 1987). An SLP should not try to elicit narratives with open-ended prompts, such as “What did you do yesterday?” It may be helpful for the SLP to establish some common experience with the child and to share a narrative about this experience as an example for the child. To get a narrative, the SLP often has to give one. Using a combination of narration and probing questions, the SLP can tell a personal story related to a common event, such as going to the doctor, and prompt the child with leading questions to stir the child’s memory of past events (“Have you ever been to the doctor?”). Experiential topics prompted in this fashion usually result in the longest and most complex narratives. Topics such as a new sibling or a death usually result in very truncated narratives. Rather the child can be prompted to relate the scariest or funniest thing that ever happened (Garnett, 1986). In addition, the child might be asked to relate a favorite movie, television show, or story, although these prompts may elicit a sequential list of events (McCabe & Rollins, 1994). The SLP should add nothing to the child’s narrative other than feedback in the form of “uh-huh,” “okay,” “yeah,” “wow,” or a repetition of the child’s previous utterance. These neutral but enthusiastic responses will not influence the course of the story as others might. The narrative can be resumed or the child prompted to continue by such utterances as, “And then what happened?” Stories are enhanced by familiarity with the listener and the location. The SLP should decide ahead of time on strategies for terminating rambling stories and for probing to elicit longer ones. A suggested guideline is not to expect children to engage in storytelling unless their MLU is 3.0 or more (Hedberg & Stoel-Gammon, 1986). Finally, the SLP will want to collect more than one from a child.

Narrative Analysis Narrative analysis is a portion of an overall language analysis occurring at both macro (overall) and micro (finite) levels. Macrostructural analysis examines hierarchical organization, such as story grammar, while microstructural considers internal linguistic structures, such as dependent clauses and con-

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junctions. Macrostructural analysis can occur in several ways, such as narrative levels, high points, story grammars, and cohesive devices (Lahey & Silliman, 1987). Narrative levels are concerned with the structural relationship of the narrative parts to the narrative as a whole. Events may be seemingly unorganized or organized sequentially or by causality. Narrative levels do not have a goal-based organization, whereas story grammars (what happens in the story) do. Narrative level analysis is most appropriate for the stories of 2- to 5-year-olds (Applebee, 1978) and for school-age children with limited verbal abilities; story grammar analysis is best for those over age 5 (Glenn & Stein, 1980). The narratives of preschool children may be evaluated also by using high-point analysis to determine the type of narrative structure (McCabe & Rollins, 1994). Story grammars describe the internal structure of a story, including its components and the rules underlying the relationships of these components (Stein & Glenn, 1979). By serving as a framework, story grammars may facilitate narrative comprehension and may be used to remember and interpret stories and to anticipate content. Cohesion analysis describes the linguistic devices used to connect the elements of the text. In narratives, coherence, or making sense, is conveyed through cohesion. Inappropriate or inadequate use of cohesive devices results in a disjointed text that is difficult to comprehend. From the analysis, an SLP should address the following questions (J. Johnston, 1982): the narrative contain chains? If so, what type? • Does the narrative follow the typical story grammar model? Is the story organized maturely? • Does are the guiding scripts of the narrator, and what do they reveal about the storyteller’s knowl• What edge of events and expectations? • What linguistic means are used to create a cohesive unit? In addition, the SLP is interested in the sensitivity of the narrator to the perceived needs of the listener. NAR RATIVE LEVE LS Children use two strategies for organizing their stories: centering and chaining. Centering is the linking of attributes or objects to form a story nucleus. The links may be based on similarity or complementarity of features. Similarity links are formed by perceptually observed attributes, such as actions, characteristics, and scenes or situations. Causal links are not present, although sequential ones may be. Complementary links consist of conceptual bonds based on abstract, logical attributes, such as members of a class or events linked by cause-and-effect bonds. Chaining consists of a sequence of events that share attributes and leads directly from one to another. Most stories of 2-year-olds are organized by centering. By age 3, however, nearly half of the children use both centering and chaining. This percentage increases, and by age 5, nearly three-fourths of the children use both strategies. These organizational strategies can result in six basic developmental stages of story organization (Applebee, 1978), presented here in developmental order: Heaps are sets of unrelated statements about a central stimulus. The statements identify aspects of the stimulus or provide additional information. The common element may be the similarity of the grammatical structure, for there is no overall organizational pattern. Dogs wag their tails and bark. Dogs sleep all day. A dog chased a cat.

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Sequences include events linked on the basis of similar attributes or events that create a simple but meaningful focus for a story. The organization is additive, and sentences may be moved without altering the narrative. I ate a hamburger. And Johnny too. Mommy ate a chicken nuggets. Daddy ate a fries and coke. Primitive temporal narratives are organized around a center with complementary events. I go outside and swing. Bobby push swing. I go high and try to stop. I fall. And I start to cry. Bobby pick me up. Unfocused temporal chains lead directly from one event to another, while linking attributes, such as characters, settings, or actions, shift. This is the first level of chaining, and the links are concrete. As a result of the shifting focus, unfocused chains have no centers. The man got in his boat. He rowed and fished. He ate his sandwich. (Shift) The fishes swimmed and play. Fishes jump over the water. Fishes go to a big hole in the bottom. (Shift) There’s a dog in the boat. He’s thirsty. He jump in the water. Focused temporal or causal chains generally center on a main character who goes through a series of perceptually linked, concrete events. This boy, he found a jellybean. And his mother said not to eat it. And he did. And a tree growed out of his head. Narratives develop the center as the story progresses. Each incident complements the center, develops from the previous incident, forms a chain, and adds some new aspect to the theme. Causal relationships may be concrete or abstract and move forward toward the ending of the initial situation. While young school-age children both with LI and without use scripts for familiar events in their narratives, children with LI often omit causal links to tie together the elements of the script (Hayward, Gillam & Lien, 2007). There is usually a climax. There was a boy named Juan. And he got lost in the woods. He ate plants and trees. And he was friends with all the animals. He builded a tent to live in. One day, he builded a fire, and the policemen found him. They took Juan home to his mommy and daddy. Each narrative can be divided into episodes that are analyzed according to this scheme. Table 8.1 contains examples of narratives and their analysis by narrative level. H IG H-POI NT ANALYSIS High-point analysis is a method for identifying narrative macrostructure. The high point, or most significant point of a narrative, is revealed not in the past events recalled, but in an event’s meaning to the narrator. The accompanying structure has developmental significance. It is best for high-point analysis to use narratives that describe events in which the narrator is present (McCabe & Rollins, 1994). An SLP should select the longest personal event narratives for analysis. Length and complexity have been shown to be related (McCabe & Peterson, 1990). The narratives of some children with LI may have very poorly defined boundaries that make this demarcation difficult. The evaluated high point is marked by children in many ways. These markings include paralinguistic features, such as emphasis, elongation, and use of environmental noises (“It went BOOM!”);

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Narrative-Level Analysis

Example

Classification

Simple frames Granma lives on a farm. There are horsies and piggies. The cows moo. I can ride on the tire swing in a tree. And the calf licked me. That’s all.

Sequence

Once there was two kids, Cassidy and . . . and Fred. Fred’s a funny name. And they was fighting. Their mother said, “Why are you fighting?” Cassidy and Fred doesn’t know why. They stop and be friends.

Focused chain

Complex narrative frame with episodic development The kids all went to Burger King on Halloween. Super Zhiming—that’s me—got a cheeseSequence burger. My sister got a Whopper. Mommy and Daddy got nuggets and salad bar. They were r eating when a big ghost came out of my milkshake. He threw milkshake on everyone and t Narrative got them mad. Super Zhiming stuck the ghost with a fork. The ghost got flat. All the air came out. Daddy was so happy that he buyed ice cream cones for all the kids.

and linguistic features, such as exclamations (“Wow!”), repetition, attention getters (“Here’s the best part.”), exaggeration, judgments or evaluative statements (“It was my favorite.”), emotional statements, and explanations (McCabe & Rollins, 1994). Once he or she has identified the high point of the narrative, an SLP can analyze for narrative structure. Different types of structures are presented in Table 8.2. Next to each is the age at which

TABLE 8.2

High-Point Narrative Structure

Narrative Structure

Characteristics

Expected Age in Years

One-event narrative

Contains one event.

Below 3.5

Two-event narrative

Contains 2 past events but no logical or causal relationship in the real world or in the narrative.

3.5

Miscellaneous narrative

Contains 2 or more past events that in the real world are logically or causally related.

Very low frequency at all ages (3.5–9)

Leapfrog narrative

Contains 2 or more related past events, but the order does not mirror the real-world relationship.

4

Chronological narrative

Contains 2 or more related past events in a logical or causal sequence without a high point.

Present at all ages (3.5–9)

End-at-high-point narrative

Contains 2 or more related past events in a logical or causal sequence with a high point but no following events (resolution).

5

Classic narrative

Contains 2 or more related past events in a logical or causal sequence with both a high point and a resolution.

6+

Source: Adapted from McCabe & Rollins (1994).

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these structures are most common for Caucasian, English-speaking, North American children. The SLP can use this table to determine whether the child is using narrative structures typical of his age group. After age 5, fewer than 10 percent of children produce one-event, two-event, leapfrog, and miscellaneous narratives. Obviously, a small sample of a few narratives will be needed for an adequate evaluation. Normal variations are to be expected within and across children. Many young children will “test the waters” by stating the high point first (“I got stung by a bee”) and then, if it is accepted, will proceed with the narrative. This is not an example of impaired narration and can be analyzed by using the suggested narrative structures when the entire narrative is told. Cultural differences must be considered too. African American children often tell topic-associating narratives in which events that happened at different times and places may be combined around a central theme. The narratives of Japanese children may be succinct collections of experiences, rather than single detailed sequential events (Minami & McCabe, 1991). Children from Latino cultures often do not relate sequential events (Rodino, Gimbert, Perez, Craddock-Willis, & McCabe, 1992). STORY G RAM MAR S Story grammars provide an organizational pattern that can aid information processing (J. Johnston, 1982b). The competent storyteller constructs the story and the flow of information in such a way as to maximize comprehension. The SLP notes the story grammar elements present in a child’s story and produces a model of the child’s story grammar (S. Chapman, 1997; F. Roth, 1986). A story consists of the setting plus the episode structure (story = setting + episode structure) (J. Johnston, 1982). Each story begins with an introduction contained in the setting, as in “Once upon a time in a far-off kingdom, there lived a prince who was very sad . . .” or “On the way to work this morning, I was crossing Main Street . . . ,” or simply “We went to the zoo today.” An episode consists of an initiating event, an internal response, a plan, an attempt, a consequence, and a reaction. An episode is considered to be complete if it contains an initiating event or response to provide a purpose, an attempt, and a direct consequence (Stein & Glenn, 1979). Episodes may be linked additively, temporally, causally, or in a mixed fashion. A story may consist of one or more interrelated episodes. The seven elements of story grammars occur in the following order (Stein & Glenn, 1979): 1. Setting statements (S) that introduce the characters and describe their habitual actions, along with the social, physical, and/or temporal contexts that introduce the protagonist. 2. Initiating events (IE) that induce the character(s) to act through some natural act (e.g., an earthquake), a notion to seek something (e.g., treasure), or the action of one of the characters (e.g., arresting someone). 3. Internal responses (IR) that describe the characters’ reactions, such as emotional responses, thoughts, or intentions, to the initiating events. Internal responses provide some motivation for the characters. 4. Internal plans (IP) that indicate the characters’ strategies for attaining their goal(s). Children rarely include this element. 5. Attempts (A) that describe the overt actions of the characters to bring about some consequence, such as attain their goal(s).

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6. Direct consequences (DC) that describe the characters’ success or failure at attaining their goal(s) as a result of the attempt. 7. Reactions (R) that describe the characters’ emotional responses, thoughts, or actions to the outcome or preceding chain of events. The two very different stories in Table 8.3 present examples of different story grammars. There is a sequence of stages in the development of story grammars (Glenn & Stein, 1980). Certain structural patterns appear early and persist, whereas others are rather late in developing. The overall developmental sequence is as follows, although much individual variation exists: Descriptive sequences consist of descriptions of characters, surroundings, and habitual actions. There are no causal or temporal links. The entire story consists of setting statements. This is a story about my rabbit. He lives in a cage. He likes to hop around my yard. He eats carrots and grass. The end. Action sequences have a chronological order for actions but no causal relations. The story consists of a setting statement and various action attempts. I had a birthday party. (S) We played games and winned prizes. (A) I opened presents. (A) I got balloons. (A) I blowed out the candles. (A) We ate cake and ice cream. (A) We had fun.

TABLE 8.3

Story Grammar Examples

Narrative

Story Grammar Elements

I. Single Episode There was this girl, and she got kidnapped by these pirates. So when they were eating, she cut the ropes and got away. And she lived on a island and ate parrots.

Setting statement (S) Initiating event (IE) Attempt (A) Direct consequence (DC) Reactions (R)

II. Multiple Episodes Once there was this big dog on a farm. And he got hungry ’cause there wasn’t enough food. The dog . . . his name was Max . . . was sad with no food, so his owner went to find some. He met a witch, but she wouldn’t give him food ’til he killed a yukky toad. He was scared but he decided to build a trap. He dug a hole and filled it with frog food. The frog wanted to eat the man but got caught. The man went back to the witch and she got some hamburgers for the man and the dog. And the man and Max ate hamburgers and were happy.

Setting statements (S) Initiating event1 (IE1) Internal response1 (IR1) Attempt1(A1) Initiating event2 (IE2) Internal response2 (IR2) Internal plan2(IP2) Attempt2(A2) Direct consequences2 (DC2) Direct consequence1 (DC1)

Reaction1 (R1)

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Reaction sequences consist of a series of events in which changes cause other changes, with no goaldirected behaviors. The sequence consists of a setting, an initiating event, and action attempts. There was a lady petting her cow. (S) And the cow kicked the light. (IE) Then the police came. (A) Then a fire truck came. (A) Then a hook-and-ladder came. (A) And that’s the end. (S) Abbreviated episodes contain an implicit or explicit goal. At this level, the story may contain either an event statement and a consequence or an internal response and a consequence. Although the characters’ behavior is purposeful, it is usually not premeditated. There was a mommy and two kids. (S) And the kids baked a cake for the mommy’s birthday. (S) They forgot to turn on . . . off the stove and burned the cake. (IE) The kids went to the store and buyed a cake. (C) The end. (S) Complete episodes contain an entire goal-oriented behavioral sequence consisting of a consequence statement and two of the following: initiating event, internal response, and attempt. This man was a doctor. (S) He made a monster. (IE) And it chase him around his house. (IE) He run in his bedroom. (A) He push the monster in the closet. (A) And the monster go away. (C) That’s all. (S) Complex episodes are expansions of the complete episode or contain multiple episodes. Once there was this Luke Skywalker. (S) And he had to fight Darf Invader. (S/IE) They fought with swords. (A) And he killed him. (C) And he got in his rocket to blow up these kind of horse robots. (IE) And he shot them. (A) Then all the bad soldiers were killed. (C) Interactive episodes contain two characters who have separate goals and actions that influence each other’s behavior. Sally never helped her mom with the dishes. (S) She got mad and said that Sally had to do it. (IE) So, Sally washed the dishes but she was mad. (IR) Then Sally dropped some dishes. (A) Then she dropped more. (A) And her mom said that she didn’t have to do any more dishes. (C) And Sally watched TV every night after dinner. (S) Specific structural properties associated with each structural pattern are listed in Table 8.4. Children with LD produce fewer mature episodes than do their age-matched TD peers. In addition, children with LD make fewer complete setting statements and are less likely to include response, attempt, and plan statements in their narratives (F. Roth & Spekman, 1986). Inter-episodic relations are also weaker in the narratives of children with LD. Story grammar analysis alone may lack the sensitivity to differentiate children with LI from those without (Hewitt & Duchan, 1995; Merritt & Liles, 1987; Ripich & Griffith, 1988). The portrayal of subjective states—think, remember, feel, know—as in the internal response element of story grammars is especially difficult for children with LI and may be central to narratives (Astington, 1990). Unfortunately, there are few normative data for clinical use. In general, children developing typically produce all of the elements of story grammar by age 10. Children’s narratives can be used, however, to approximate their functioning level and to determine which structural elements are present (Hedberg & Stoel-Gammon, 1986). Table 8.5 on page 228 contains several narratives analyzed by story grammar structural pattern and narrative level.

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Structural Properties of Narratives

Structural Patterns

Structural Properties

Structural Patterns

Structural Properties

Descriptive sequence

Setting statements (S)(S)(S)

Complex episode

Action sequence

Setting statement (S) Attempts (A)(A)(A)

Reaction sequence

Setting statement (S) Initiating event (IE) Attempts (A)(A)(A)

Abbreviated episode

Setting statement (S) Initiating event (IE) or Internal response (IR) Direct consequence (DC)

Complete episode

Setting statement (S) Two of the following: Initiating event (IE) Internal response (IR) Attempt (A) Direct consequence (DC)

Multiple episodes Setting statement (S) Two of the following: Initiating event (IE1) Internal response (IR1) Attempt (A1) Direct consequence (DC1) Two of the following: Initiating event (IE2) Internal response (IR2) Attempt (A2) Direct consequence (DC2) Expanded complete episode Setting statement (S) Initiating event (IE) Internal response (IR) Internal plan (IP) Attempt (A) Direct consequence (DC) Reaction (R)

Interactive episode

Two separate but parallel episodes that influence each other

EXPR ESSIVE E LAB ORATION Expressive elaboration occurs when the storyteller goes beyond information transmission and creates a pattern of theme, structure, story genre, and mood. The result is an interesting or well-crafted narrative. The skilled narrator selects words and sentence structure to attain his or her desired affect on the listener. For example, the narrator might withhold certain information in order to build suspense or choose words that create a specific illusion. Even real-life narratives may include fictionalized elements that increase listener interest. Three types of expressive elaboration may be evaluated: appendages, orientation, and evaluation (Ukrainetz, Justice, Kaderavek, Eisenberg, Gillam, et al., 2005). Appendages alert the listener that a story is being told or ended and consist of five categories: or opening elements (One morning last week . . .). • Introducer Abstracts, which • when I . . .). provide summaries of events prior to the narrative (This is about what happened which provide summaries within the narrative (This is why I’m so grouchy today) • Themes, Codas, which are general observations that show the effect on the narrator or characters (So I • learned not to drive too fast). Enders (The end). •

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Communication Assessment

Story Grammar Analysis

Narrative

Story Grammar Elements

I. We went to a farm. I got to feed chickens. Then I saw cows in the barn. Cows give milk. Cows stay in the field all day and eat grass. At night they come in.

(S) (S) (S) (S) (S) (S)

II. There was this boy who lived in a city. And one day a giant bug got out of this place where they keep bugs. And the boy got in an airplane and shot it. III. Once there was two boys. One boy fell into a big hole with rats and he was scared. His brother got a ladder but the rats ate it. So, he threw his lunch in the hole. The rats ate it, too, and the boy climbed up a rope and was safe.

(S) (IE)

Structural Pattern

Narrative Level

s

Descriptive sequence

Unfocused temporal chain

r

Reaction sequence

Focused temporal chain

t

Complex episodes

Narrative

(A) (S) (IE1) (IR1) (A1) (DC1/IE2) (A2) (DC2) (R)

Note: Even though the third narrative possesses advanced structural properties, it demonstrates some pronoun confusion. The relationship of the boys is not established until the third utterance.

Orientations are setting statements and consist of three categories: (Jill). • Names Relations, describe roles or jobs (my teacher). • Personalitywhich attributes that persist throughout the narrative (lazy). • Finally, evaluation describes how the narrative and character perspectives are delivered. Evaluation consists of five categories: modifiers, which consist of most descriptive adjectives and adverbs. • Interesting Expressions, are multiword modifiers (tired as a marathon runner). • Repetition ofwhich nouns, or verbs (walked and walked and walked) for effect. • Internal state words,adjectives, which reflect thoughts (remembered), feelings (depressed), reactions • (surprised), intentions, and physical states (tired). Dialogue (So she said . . .). • By age 9, all typically developing children should exhibit some expressive elaboration in their narratives. Naturally, these vary by type of elaboration, so several narratives are required for a full picture of a child’s abilities. Table 8.6 presents narratives with varying types of expressive elaboration.

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Types of Elaboration Found in Narratives by Age 9

Evaluations—Most frequent; increase with age Modifiers

Adjective, adverbs, and adverbial phrases*

mighty, angry, shy, slowly, in between

Expressions

Multiword modifiers

as quietly as she could, wrong side of the tracks, all of a sudden

Repetition

Repetition of a word for emphasis

He ran and ran to get way, They were very, very happy

Internal States

Words reflect intentions, thoughts, feelings, emotions, motivations, and reactions

thought, sad, angry, tired, decided, planned

Dialogue

Portions of narrative in which characters speak

She shouted, “Stop that!”

Orientations—Increase with age Names

Characters identified specifically on first mention

King Juan, Jack, Monica

Relations

Relationships of jobs defined

Monica’s sister, teacher, pet

Personality

Personal attributes that endure throughout the story

always late, too young to, grumpy old woman

Appendages—Least frequent; increase with age Introducer

Beginning of narrative marked

Once upon a time, One night, Yesterday

Abstract

Summary prior to narrative or story title

This is a story about why you you shouldn’t run away, This is called “My Best Day”

Theme

Summary within narrative

And this is why he was so scared

Coda

Effect of narrative or lesson learned

So they decided never to ride their bikes in the woods again

Ender

Formal indication narrative is over

That’s it, The end, And they lived happily . . .

*Some occur so frequently that they should not be noted. These include some, other, another, one, little, big, bad, on top, outside, behind, and after. Source: Compiled from Ukrainetz, Justice, Kaderavek, Eisenberg, Gillam, & Harm (2005).

QUANTITATIVE M EASU R ES Several microstructural measures vary significantly with age. These are total number of words (TNW), number of different words (NDW), total number of T-units (LENGTH), mean length of T-units in words (MLT-W), total number of T-units that contain two or more clauses (COMPLEX), and the proportion of complex T-units (PROCOMPLEX) (Justice, Bowles, Kaderavek, Ukrainetz, Eisenberg, et al., 2006). These values are presented in Table 8.7. Be cautioned that these data are from a pilot study, albeit a well-done one, and that there is wide variability among TD children, as seen in the standard deviation (SD). Within one standard deviation is where the normal population is considered to be. Episodic structure and syntactic accuracy are good measures of language in children from CLD backgrounds (Muñoz et al., 2003). More semantically based quantitative measures, such as the number of different words, seem to vary with the method of elicitation (Uccelli & Páez, 2007).

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TABLE 8.7

Narrative Microstructure

Age

TNW M

SD

NDW M

SD

LENGTH M

SD

5

68

(± 47)

39

(± 20)

8.5

(± 5.4)

6

77

(± 54)

43

(± 22)

9.6

(± 6)

MLT-W M

SD

COMPLEX M

SD

PROCOMPLEX M

SD

6.8 (± 1.7)

3.1

(± 3.2)

.33

(± .2)

7.5

(± 1.6)

3.5

(± 2.8)

.37

(± .2)

7

96

(± 74)

52

(± 28)

11.3

(± 9.1)

8.5 (± 3.8)

4.6

(± 4.3)

.38

(± .2)

8

137

(± 77)

69

(± 27)

15.8

(± 8.9)

8.1 (± 1.4)

7.6

(± 5.2)

.45

(± .2)

9

162

(± 96)

79

(± 30)

17.3

(± 9.6)

8.4 (± 1.4)

8.9

(± 6.1)

.51

(± .2)

10

237

(± 196)

101

(± 49)

21.5

(± 14.5)

8.9 (± 2.1)

12.2

(± 9.8)

.55

(± .2)

Note: Columns include total number of words (TNW), number of different words (NDW), total number of T-units (LENGTH), mean length of T-units in words (MLT-W), total number of T-units that contain two or more clauses (COMPLEX), and the proportion of complex T-units (PROCOMPLEX). Source: Adapted from Justice, Bowles, Kaderavek, Ukrainetz, Eisenberg, & Gillam (2006).

COH ESIVE DEVICES Children with LI and those with poor reading abilities exhibit some difficulty communicating wellorganized, coherent narratives (Norris & Bruning, 1988). In general, they produce event and essential relationships more poorly than do their age-matched TD peers (J. Johnston, 1982; Liles, 1985a, 1985b, 1990; Merritt & Liles, 1985). The most common cohesive errors among children with LI are an incomplete tie, in which the child references an entity or event not introduced previously, and an ambiguous reference, in which the child does not identify to which of two or more referents she or he is referring (Liles, 1990). Of interest in the text are cohesive devices that linguistically connect the components. In short, any sentence element that sends the listener outside of the sentence for a referent is a cohesive device. For example, a pronoun may require referral to the previous sentence in order to determine the referent. The five types of cohesive relations are reference, substitution, ellipsis, conjunction, and lexical items. Of these, lexical cohesion may be the most difficult to assess reliably (Liles, 1990). Because there is little normative data on the development of these relations, descriptive analysis is the best diagnostic approach. In general, mature story grammar develops prior to mature use of cohesive devices. It is possible, therefore, to have good episodes but poor cohesion. The two are related but not dependent. The cohesion within and between episodes becomes important as children develop complex and interactive episodes. There is a metalinguistic quality about cohesion in that the speaker must pay attention to the text apart from the story itself. Cohesive relations are discussed in Chapter 6 and are reviewed only briefly in this section. Cohesion repairs require particular organizational strategies not found in conversation. Older children, aged 8.5 to 12.5, most often make meaning repairs in narratives and in conversation, recognizing the importance of being comprehended successfully (MacLachlan & Chapman, 1988; Purcell & Liles, 1992). Cohesion repairs are made frequently by both children developing typically and those with LI, but with different levels of success (Purcell & Liles, 1992). In general, both types of children are equally successful with repairs within T-units, usually consisting of single-word repair. In repairs across T-units, requiring reorganization of several sentences, however, children with LI are less success-

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ful. This difference may reflect underlying language skills and processes (Butler, 1986; L. Miller, 1984; Van Kleeck, 1984; Wallach & Liebergott, 1984). Reference Reference devices, which refer to something else in the text for their interpretation, consist of pronouns, definite articles, demonstratives, (this, that) and comparatives (bigger shown). The link with the referent should be clear and unambiguous. Clarity is often a problem when a child changes the story narrator frequently, uses dialogue, or includes several characters. Pronouns and definite articles are used to refer to referents previously identified in the narrative. Narrative analysis, especially semantic elaboration and pragmatic inappropriateness, appears to be an appropriate way to assess the language differences of children, especially those with FASD (Thorne, Coggins, Carmichael Olson, & Astley 2007). Semantic elaboration is measured by the use of nouns and pronouns to reduce ambiguity in the narrative, the specificity of the nouns and verbs used to introduce an entity (thing vs. hammer) or action (went vs. drove), and noun and verb elaborators (large angry dog and ran quickly, respectively). The Semantic Elaboration Coding System (Thorne, 2004) offers a convenient way to analyze this data. In contrast, demonstratives locate referents on a continuum of proximity. Nominals, such as this, that, these, and those, refer to a person or a thing; adverbs, such as here, there, now, and then, refer to a place or a time. Use of now and then usually is restricted to referring to the time just mentioned. In addition, now and then can serve as conjunctions. Finally, comparatives are both general, referring to similarities and differences without reference to a particular property, and specific, referring to some specific quantity or quality. General comparatives include such words as another, same, different(ly), equal(ly), unequal, identical, similar(ly), and else. Specific quantity words include more, less, so many, as few as, second, further, and fewer than. Quality words and terms consist of worse than, as good as, equally bad, better, better than, happier than, and most happy/happiest. Substitution and Ellipsis Substitution and ellipsis both refer to information within the narrative that supposedly is shared by the listener and the speaker. In substitution, another word is used in place of the shared information. The words one(s) and same can be substituted for nouns, as in “Make mine the same” or “I’ll take one, too.” Such words as do can be substituted for main verbs, as when we emphasize,“I did already.” Finally, such words as that, so, and not can be substituted for whole phrases or clauses, as in “I think not” or “Mother won’t like that.” Ellipsis differs from substitution in that shared information simply is omitted. Whole phrases and clauses may experience ellipsis. Any portion of the noun phrase may be omitted, as in the following examples: I have four of her brightly wrapped red gifts. Which is yours? Would you like two? Do you have green? Verbal material also may be omitted, as in the response “He can’t” to the question “Will John attend the concert tonight?” Clausal ellipsis may be demonstrated with the same question when the answer is “Probably.”

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Conjunction The four types of conjunctive relations are additive, temporal, causal, and adversative. Whereas additive relationships usually are represented by and, temporal ones may be signaled with a variety of words, such as then, next, after, before, at the same time, finally, first, second, and an hour later. Causal conjunctive relationships may be expressed with a variety of terms, such as because, as a result of, in that case, for, and so. Finally, adversative conjunctions include but and others, such as however, although, on the other hand, on the contrary, except, and nevertheless. Conjunction use may be independent of the specific clausal structures linked. In other words, conjunctions link the underlying semantic concepts and thus represent the relationship of these units, which may be expressed by various syntactic units. The way episode parts are linked may reflect a child’s underlying episodic organization. We would expect, therefore, that conjunctive relationships between episodic elements would be more complex and difficult than those between sentences. This increase seems to be true for both children with LI and those without (Liles, 1987). This may account for the fewer conjunctions found in the narratives of children with LI (Greenhalgh & Strong, 2001). Lexical Items Words themselves express relationships by the morphological endings used. For example, the present progressive -ing ending is used to express actions taking place at the present time. The following example demonstrates a clear understanding of the relationship of the process to the product: He had been writing for several months. After the book was finally written, he celebrated for days. He swore never to write another novel. Categorical relationships can be expressed and demonstrate convergent and divergent organizational patterns. Convergent thought goes from the members to the category, as in “She had petunias, dahlias, roses, and pansies in her garden, but she could never have enough flowers.” Divergent thought goes from the category to the members, as in “She liked several kinds of sports but was best at soccer, rugby, and lacrosse.” Finally, words can express relationships, such as opposition or part-to-whole. In a narrative, the SLP can look for antonyms, synonyms, ordered series, and part-whole or part-part relationships. Ordered series include memorized sequences, such as the days of the week, or hierarchies, such as instructor, assistant professor, associate professor, and full professor. Part-whole relationships are expressed by entities that form a portion of the whole, as in rudder-boat, pedal-bike, and Januaryyear. Finally, part-part relations contain parts of the same whole, as in nose-chin, finger-thumb, and rudder-sail. Conclusion Narratives require the manipulation of extended units of language. Cohesive devices are indirectly assessed by certain quantitative measures. R E LIAB I LITY AN D VALI DITY Narrative analysis is not without its detractors. The reliability and validity of narrative analysis as a clinical tool has been questioned (Klecan-Aker & Carrow-Woolfolk, 1987). Naturally, reliability and validity will vary with the aspects of narratives measured.

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Establishing developmental level by the number of story grammar components present appears to have very high inter- and intrajudge reliability (Klecan-Aker & Hamburg, 1991; Klecan-Aker, Swank, & Johnson, 1991). This developmental level and other quantitative measures, such as words per T-unit and words per clause, also correlate strongly with language test scores, suggesting that narrative analysis has strong construct validity.

Children with CLD Backgrounds Children entering school with good narrative abilities are better prepared to comprehend and produce the decontextualized language of reading and writing (Gee, 1989; Westby, 1984). Other children are at greater risk of academic failure (Orum, 1986; U.S. Bureau of the Census, 1990). To tell, retell, or comprehend the literate narratives found in English, a child must have a concept of story grammar and a cultural script for the story. Narrative performance among various cultural, ethnic, and linguistic groups may differ greatly. These differences reflect both cultural and individual differences in storytelling. Storytelling is never context or culture free (Gutierrez-Clellan & Quinn, 1993). Rather, it is the product of the contextual interaction of the narrator and the audience and of the sociocultural norms of each, which shape each person’s presuppositions and expectations. Even the purpose and context for narratives varies across cultures. Telling narratives is a social event governed by cultural norms and values. Not every culture expects the narrative monologues seen in American English. Among some Latinos, Native Americans, African Americans, Jewish Americans, and Hawaiian Americans, stories are produced conversationally with audience cooperation. The story is built by the storyteller acting out the parts as the audience challenges and contradicts. Narrative completeness will reflect also each child’s experience and world knowledge (Ross & Berg, 1990). Pictures and topics that are used to elicit a child’s narrative may be beyond the child’s experiential base and result in diminished performance. It is difficult for children to tell stories with unfamiliar scripts. A child unfamiliar with a farm, for example, may use the word truck for tractor and garage for barn. Even the temporal qualities of narratives reflect the temporal realities of different cultures. The importance of seconds, minutes, and hours in Western culture is not found in others. A good friend once told me of his grandfather, a Cherokee elder, who measured time by the slow, purposeful movement of the earth and moon. A Bolivian American friend laughingly confided that her parents usually arrived at a wedding in time to throw the rice. Narratives in Standard American English dialects tend to be linear and temporal-causal. This is not true of all dialectal speakers. The narratives of Athabaskans, a native Alaskan people, are spatially or circularly organized (Silliman, Diehl, Aurillo, Wilkinson, & Hammargren, 1995). Many Native American narratives stress community, harmony, and tribe rather than individual actions to overcome some challenge (Westby & Roman, 1995). Although the narratives of speakers of African American English are linear, they meander more than those of majority speakers and, thus, are longer, with more shifts of time, place, and characters. Many of the aspects of narrative analysis discussed previously are based on American English forms and cultural expectations, such as the narrative organization and the use of linguistic devices. The analysis in this chapter assumes that all narratives are composed of an elaborated story grammar. Episodic structure and content vary with culture (Kay-Raining Bird & Vetter, 1994). The

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narratives of the Athabaskan people characteristically include four actors, four major instruments of action, and four sections: introduction, scene 1, scene 2, and closing (Silliman et al., 1995). In contrast, the narratives of Japanese children are very sparse, consisting of two-unit episodes: a challenge and a consequence. Likewise, the narratives of African American children have fewer formal beginnings and endings and less chronology while containing more judgments on characters and their actions (Heath, 1983). In addition, the stories of African American and Puerto Rican children embed such evaluations within the narrative and are less likely than European American children to state the point of the story explicitly at the end (Iglesias, Gutierrez-Clellan, & Marcano, 1986). Grammatical contrasts offer further examples. In Spanish, referential cohesion is demonstrated in the introduction of and the later referral to different entities in the story. Characters, props, and places may be referenced by the nominal (un nene/a boy), elliptical (El fue a la tienda, cogio un poco de comida/He went to the store, got some food) (Gutierrez-Clellan & Heinrichs-Ramos, 1993, p. 560), or the demonstrative (este/this). In addition, both characters and props may be referenced by the pronominal (elle/she). With increasing age, Spanish-speaking and English-speaking children use ellipsis more for place (Gutierrez-Clellan & Heinrichs-Ramos, 1993). Once the setting has been introduced, it is not named again unless changed. Whereas the use of ellipsis in English requires previous reference, speakers of Spanish may omit referential information because verb endings mark this information (tuvo/I had; tuviste/you had). Children speaking Spanish who are familiar with this practice may omit nominal reference in English too, giving the impression that they do not understand cohesion. Still, there is much similarity in narrative development. By age 4, children speaking Spanish have a wide range of referential strategies. The nominal and elliptical forms are used for characters in the subject position, while pronominals are used for those in the object (Gutierrez-Clellan & HeinrichsRamos, 1993). As children speaking Spanish get older, a greater number of props and places are introduced, and their narratives become more detailed, though not necessarily much longer (Gutierrez-Clellan & McGrath, 1991). More and more information is embedded, decreasing the number of sentences needed to express the same information. Redundant information is omitted. The number of characters changes little, however, from ages 4.5 to 8 years. Children speaking Spanish develop causal sequences at about the same age as children speaking American English. From ages 4 to 9, there is a decrease in two-clause causal sequences and in the proportion of unrelated statements and an increase in three-clause causal sequences (Gutierrez-Clellan & Iglesias, 1992). Action sequences predominate as a means of moving the story forward. Physical and emotional states as the cause of change tend to remain stable from ages 4 to 9. Other devices, such as paralinguistics, may be used by other cultures more than by the majority American culture, which tends to rely on rising and falling intonation (Gee, 1986; Michaels, 1986). For example, African American and Puerto Rican children use more loudness, pitch, rate, stress, rhythm, and intonation along with exclamations and repetitions than do majority children to move the story forward and to make evaluative or emotional comments (Iglesias et al., 1986). In other cultures, false starts and hesitations function as internal organizers, while slower pace through repetition, redundancy, and silence may signal the point of the story or its conclusion (Gee, 1986, 1989).

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Narrative Collection and Analysis The cultural variability of narratives requires an SLP to assess narrative development in a wide variety of culturally relevant contexts approaching the natural environment of the child (Gutierrez-Clellan & Quinn, 1993). If the child does not consider the task “worthy,” he or she may give less than an optimum or even typical performance (Iglesias et al., 1986). The SLP may err on the overly cautious side by assuming that all differences are cultural or that the child can only produce narratives of a familiar type in familiar contexts. A third option, discussed previously, is a dynamic assessment that evaluates the child’s learning potential or teachability (Feuerstein, Rand, Jensen, Kaniel, & Tzuriel, 1987). A dynamic assessment of narrations consists of a collection and analysis, mediated instruction, and a second collection and analysis (Gutierrez-Clellan, Peña, & Quinn, 1995; Gutierrez-Clellan & Quinn, 1993; Peña, 2002). With school-age children, the SLP first can collect narratives in response to wordless picture books and analyzes each for the number of words, C-units, clauses, clauses/C-unit, episodic structure, story components, and story idea and language. Possible wordless picture books include Bird and His Ring (Miller, 1999b), Frog, Where Are You? (Mayer, 1969), One Frog Too Many (Mayer & Mayer, 1975), and Two Friends (Miller, 1999a). In the second step, the SLP can choose one or two areas of the narrative for a mediated language experience (MLE). The SLP helps the child explore the goals of a story, the importance of these goals, the consequences of omitting these goals, plans for using this information, and developing strategies. The second collection and analysis is similar to the first but attempts to answer five questions (Peña, 2002): Was the child able to form a more complete and coherent narrative? How difficult was it for the SLP to achieve positive change? Did the child pay attention and include more elements in the second narrative? Was the child able to transfer the learning without SLP support? Was learning quick and efficient? Children developing typically usually make rapid changes and are very responsive. For more-mature children and adolescents, several narratives can be collected in various contexts and analyzed as above and for the “rules” appropriate for each type of narration. The characteristics of each type of narration based on temporal, referential, causal, and spatial coherence are included in Table 8.8 (Gutierrez-Clellan & Quinn, 1993). The SLP must remember that the “rules” for certain types of narration may be unfamiliar to some children and may be a difference, rather than a deficit. The types of cohesion used by the child should reveal his or her narrative style. In the second step, the different types of narratives are explained to the child by using cues, such as “Talk like a book in school” or “Talk like you would to a friend,” and examples. Within the training, the child is given different types of narratives to produce. Feedback is used by the SLP to seek clarification, additional information, relevant comments, and reference. After some intervention, the SLP attempts to determine whether the child can learn different types of narration, can transfer the types of cohesion across contexts, and can tell narratives without cuing and feedback.

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TABLE 8.8

Communication Assessment

Types of Narration and Cohesion

Temporal Coherence Is there a temporal order of events? Are temporal connectives necessary? If so, are they used? Are shifts in time marked? Causal Coherence Are physical and mental states used to interconnect actions? (He was very tired, so he went to sleep.) If not, can connectives be inferred easily? Are causal connectives necessary? If so, are they used? Referential Coherence Participants Is adequate reference to the participants made? Are new characters introduced clearly? If not, are they referred to as if introduced elsewhere in the text? Are characters reintroduced in an unambiguous manner? Can the referent be inferred from general world knowledge? Props Is identification of specific objects necessary? If so, are props mentioned adequately? If not, are props introduced by gestures or deictics, such as “that thing”? Can the identity of props be inferred from descriptions or functions? Spatial Coherence Is information about location necessary? If so, are locations identified? Are shifts in location clearly marked? Source: Adapted from Gutierrez-Clellan & Quinn (1993).

Two measures that seem particularly important are the length of causal sequences and the number of unrelated statements. Among children speaking Spanish, an increase in the length of causal sequences and a decrease in the number of unrelated statements are indicators of greater causal cohesion (Gutierrez-Clellan & Iglesias, 1992). Dynamic procedures work well with children from different sociocultural backgrounds (Lidz, 1987; Peña & Iglesias, 1989; Sewell, 1987). The procedures require that the task be explained, that the reasons for certain responses be stated adequately, and that the child respond differentially to the SLP’s cues (Gutierrez-Clellan & Quinn, 1993).

Conclusion The near universal use of some form of narrative suggests its importance in communication. As in dialogue analysis, it is important to analyze narratives simultaneously at several levels. Although there are few normative data on narrative development against which to compare a child’s or adolescent’s performance in any culture, an SLP can use the model described in this chapter as a basis for analysis and description of a child’s narrative performance. In general, the more mature the narrative, the more complete the structure and the story grammar. In addition to causal chains, more-mature narratives contain greater cohesion to aid the listener

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in interpretation. Mature narratives are structurally cohesive and proceed from one event to another in a logical fashion that demonstrates the narrator’s attempt to guide the listener. More-mature narratives also include more insight into the thoughts and feelings of the central characters and greater use of devices for expressing time and place. There are fewer extraneous details and loose ends. An SLP should be cautious when evaluating children from cultures whose narratives do not closely follow the pattern described in this chapter. Children from some Spanish-speaking and some Native American cultures may have less experience with story narratives. To varying degrees, these cultures make extensive use of more descriptive narratives. The use of pictures and elicitation techniques, such as “Tell me a story about this picture,” may evoke a very different narrative from what is sought.

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3 part

Intervention

C H A PTE R 9

A Functional Intervention Model C H A PTE R 10

Manipulating Context C H A PTE R 11

Specific Intervention Techniques C H A PTE R 12

Classroom Functional Intervention C H A PTE R 13

Literacy Impairments: Language in a Visual Mode

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9

chapter

A Functional Intervention Model

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Part 3 Intervention

T

raditional language intervention does not consider either the integrated nature of language or the context of language use (Duchan, 1997). Language is viewed as a hierarchically organized set of rules, rather than as a holistic set of variable context-sensitive rules (Rice, 1986). Although the focus may include form, content, and use, the overall design is usually additive, rather than integrative. Often, the stated goal is to learn specific language units, not enhance communication. Language methods that emphasize very specific skills seem to have very specific, limited effects. There is little evidence that newly acquired forms will generalize to everyday conversational use (Olswang & Bain, 1991). Clinical intervention should be a well-integrated whole in which the various aspects of language combine to enhance communication. The purposes of intervention should be (a) to teach a generative repertoire of linguistic features that can be used to communicate in socially appropriate ways in various contexts and (b) to stimulate overall language development (Duchan, 1997; Russell, 1993; Warren & Kaiser, 1986a). A functional language intervention model attempts to target language features that a child uses in the everyday context, such as the home or the classroom, and to adapt that context so that it facilitates the learning of language. Table 9.1 presents a comparison of the traditional language intervention model with a functional integrated approach. The functional approach recognizes a need to orient language training toward the inclusion of family members and teachers as language facilitators and toward the use of everyday activities for encouraging functional communication. Therefore, routines within the home, school, and community are used with an array of language facilitators. In this way, aspects of language can be trained as they relate to one another within the context of a meaningful experience. As a result, the intervention experience more closely approximates patterns of nonimpaired language development. Content is based on common experiences. This functional approach, with its integrative and interactive aspects, changes the nature of the clinical interaction and the role of the SLP. The SLP becomes a consultant for the other language facilitators, who interact more frequently with the child, training them to modify the contexts within which language can occur and to elicit and modify the child’s language. The SLP and caregivers collaborate in the child’s language intervention. Concern for generalization is foremost and governs the overall intervention approach. Planning by an SLP, along with the language facilitators, is essential. Implementation and generalization may be hampered or impeded by any number of factors, such as the targets selected, the intervention setting, the training methods used, and caseload and scheduling considerations. Intervention should begin with a generalization plan (Stremel-Campbell & Campbell, 1985) that identifies features of a child’s communication environment relevant to generalization. All too often, generalization is the last step in the intervention planning process, rather than the overall organizing aspect. Once the appropriate generalization variables have been identified, an SLP can begin to design intervention strategies. The relevant features of the communication environment that have been identified can now be enlisted. Ideally, such intervention enables an SLP to (a) develop linguistic constructs at a child’s developmental functioning level, taking into account the strategies children normally use when acquiring language, (b) integrate all linguistic areas within the communication framework, and (c) provide meaningful and age-appropriate contexts (Gullo & Gullo, 1984). In this chapter we discuss principles of intervention in a functional approach and an overall model for intervention, focusing on the variables that affect generalization.

Chapter 9

TABLE 9.1

A Functional Intervention Model

243

Comparison of Traditional and Functional Intervention Models

Traditional Model

Functional Model

Individual or small group setting using artificial situations.

Individual or small or large group setting within contextually appropriate setting.

Isolated linguistic constructs with little attention to the interrelationship of linguistic skills.

Relationship of aspects of communication stressed through spontaneous conversational paradigm.

Intervention stresses modeling imitation, practice, and drill.

Conversational techniques stress message transmission and communication.

Little attention to the use of language as a social tool during intervention sessions.

The use of language to communicate is optimized during intervention sessions.

Little chance or opportunity to develop linguistic constructs not targeted for intervention.

Increased opportunity to develop a wide range of language structures and communication skills through spontaneous conversation and social interaction.

Little opportunity to interact verbally with others during intervention.

Increased opportunity to develop communication skills by interacting with a wide variety of partners.

Source: Adapted from Gullo & Gullo (1984).

Principles Use of a functional approach to language intervention requires an SLP to change some methods and to be mindful of certain principles that aid communication with and learning for a child. It is important to engage a child in meaningful dialogue or in some other communication event, and this event becomes the vehicle for learning and generalization. The following section includes some of the most important principles of the functional approach. Undoubtedly, some important ones have been omitted that the reader will want to include in her or his repertoire. TH E LANG UAG E FACI LITATOR AS R E I N FORCE R As communicators, we continue to interact with those individuals who provide positive feedback and reinforcement. Each of us avoids communicating with certain individuals who are nonresponsive, caustic, or overly critical. Children avoid certain potential conversational partners for many of the same reasons. If SLPs want children to communicate with them, then they must be people with whom children want to communicate. Children respond most readily to adults who convey genuine caring and respect for them. These attitudes are conveyed by meeting a child halfway. Adults who desire to be effective conversational partners must appreciate the world from a child’s perspective. Events easily understood by an adult may be quite incomprehensible to a young child. It may help to recall that for children the world is full of wonder and delight, full of things that cannot be explained, and full of magic. Adults demonstrate concern for children and adolescents when they are willing to attend to children, to listen, and to accept their topics. As much as possible, intervention should be nonintrusive, with

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facilitators providing supportive, evaluative feedback to a child. By reducing the authority-figure persona, demonstrating an attentiveness and a willingness to adopt a child’s topics, and remaining accepting while providing evaluative feedback, an SLP can send a message of acceptance of the child as a partner. Few child linguistic responses are totally wrong. Even seemingly incorrect utterances demonstrate the child’s understanding of the situation and of the underlying relationships. Acceptance of a child includes acceptance of these utterances. Usually, some portion of the utterance can be reinforced. Child: I need ear-gloves. SLP: That’s right, they are like little gloves for your ears. We call them earmuffs. Here, let me help you put on your earmuffs. The partner has accepted the child’s utterance, recognized the child’s understanding of the situation, corrected the utterance, and left the child’s ego intact. The intervention setting itself should “create and sustain an atmosphere containing fun, surprise, interest, ease, invitation, laughter, and spontaneity” (Cochrane, 1983, p. 160). In such an atmosphere, children will be eager to participate. One of my best lessons on verbal sequencing used mime, complete with whiteface. The children enacted familiar everyday event sequences, such as making breakfast, while other students tried to guess the name of the sequence. After the correct guess was given, the actor stated each event in the sequence while performing it. Finally, each actor attempted to reconstruct the sequence verbally. The lesson was messy, fun, enjoyable, and thoroughly successful. Children also respond favorably if the facilitator occasionally plays the clown or buffoon. I may wear a cooking pot on my head in order to evoke a response. On other occasions, I purposely may make incorrect verbalizations or actions. I’ve even dressed as a chicken. These behaviors add to the magic of the communication situation and encourage children to communicate in an accepting atmosphere. CLOSE APPROXI MATION OF NATU RAL LEAR N I NG Language intervention strategies should approximate closely the natural process of language acquisition. The strategy should be communicative in nature and should use language as it naturally occurs (Mahoney & Weller, 1980). Teaching language devoid of its communicative function deprives a child of intrinsic motivation and of one essential element of generalization. Natural language models—parents, teachers, aides, and others—should be the principal resources for implementation of language intervention (Broen & Westman, 1990; Crais, 1991, 1992; Hazel, 1990; Whitehurst et al., 1991). These individuals serve as language models with or without the SLP’s input. Their potential as language facilitators can be exploited best, however, when they are guided in content selection and trained in facilitative techniques. When using these language facilitators within the child’s everyday situations, the role of the SLP changes to that of collaborator. FOLLOWI NG DEVE LOPM E NTAL G U I DE LI N ES The language development of typical children can guide the selection of training targets. As a group, these children develop language in a similar, albeit individualistic, manner. Generally, language form is preceded by function, with easier, less complex structures being learned first. Children use the language they possess to accomplish their language goals. These uses are the framework within which new forms develop. The overall result is a hierarchy that suggests steps for training language.

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Of course, no SLP would ever adopt a language intervention hierarchy without adaptations for a child and the contexts in which he or she functions. Slavish adherence to a developmental hierarchy is inappropriate for two reasons. First, the typically developing child’s hypothesis testing of language rules occasionally results in nonproductive strategies. For example, young children learn a few irregular past tense verbs early in their language development. On learning the regular past tense -ed rule, these children apply it to the previously learned irregular verbs. This tactic results in such delightful forms as eated and sitted. No SLP would wish to adopt these forms as training targets, even though they appear in the language of children developing typically. Second, good teaching may suggest alternative hierarchical teaching patterns (Elbert & McReynolds, 1985; Powell, 1991). For example, children developing typically acquire the verb to be as both an auxiliary verb and as a main verb or copula. In intervention, therefore, these forms might be targeted separately. Our knowledge of carryover suggests, however, that we train them together, making little distinction between the forms and aiding generalization. An SLP should be aware of the prerequisites for successful communicative behaviors at the functioning level of a child. The child learning plurals need not be able to count but must have a notion of one and more than one. Likewise, successful use of why questions and answers requires an ability to reconstruct events in reverse. These cognitive skills may need to be taught prior to attempting the linguistic manner for noting this knowledge. Similarly, the child needs to understand the requirements and demands of different communication situations to communicate effectively within them. For example, the requirements of classroom give-and-take are very different from having a face-to-face conversation or from talking on the telephone. As with much learning, simple rules are combined and modified or enlarged to form higher-order rules. By carefully analyzing each new training target and monitoring progress, an SLP can ensure that a child possesses the appropriate rules for new learning. It is best not to change too many aspects of the training situation at one time. For example, words used frequently by a child should be selected to train longer utterances. New words and new forms together are too challenging. Children with LI will not present textbook examples of language development hierarchies. Language development and impairment can be very individualistic and may not follow the dictates of a developmental hierarchy. Aspects of language will develop at rates influenced by perception and cognition, opportunity, needs, and training. Of more importance for intervention is the designation of training targets that help the child function more effectively within the everyday environment. The language rules observed by most children at each level of development are valid for those children at that time. For example, young children say such things as “Mommy eat” and “More juice,” which demonstrate adherence to simple word sequencing rules based on semantics. Children demonstrate rules appropriate to their level of linguistic competence. At various levels of intervention, it is appropriate to target child rules rather than the more difficult adult ones that will be trained later. A child with LI who is forming negatives, such as no + noun + verb, should make a logical progression to noun + no + verb, rather than to the adult rule with full auxiliary verb. To require children with LI to use adult sentence forms seems ridiculous, especially when we do not require such behavior from children developing typically. As adults, we sometimes think that the adult way of doing things is the only way. Even the expectation that a child will use a new or adultlike language rule or feature following brief periods of intervention may be unrealistic (Fey, 1988). Children developing typically learn and extend or retract their language rules gradually after many encounters and trials. Over time, these rules come

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to resemble those of adults. Therefore, it is inappropriate to expect near perfect performance from children with LI shortly after a target is introduced. Rule learning is complicated and time-consuming. In addition, children with LI may form rules very different from those intended by SLPs, therefore necessitating additional training. As a child progresses, the language training should be modified accordingly. In other words, the SLP ups the ante (MacDonald, 1985), or requires performance just above the child’s current functioning level. FOLLOWI NG TH E CH I LD’S LEAD Often, the expectation that a child will not communicate effectively becomes self-fulfilling. If facilitators expect a child to communicate and plan for it, the child will. It is important that the facilitator attend to the content and intent of each child utterance and respond appropriately. Thus, “teaching occurs when a child is attending and because the language being taught to the child is a positive consequence” (Warren & Rogers-Warren, 1985, p. 7). Language facilitators can choose either to direct and maintain a child’s attention or attend to what interests the child (Kovarsky & Duchan, 1997). Although the former is a trainer-oriented approach (or adult-centered) that gives the trainer virtual control of the entire interaction, it may not be the most effective approach. For example, children with ID are less likely to follow such trainer attempts to redirect attention (Landry & Chapieski, 1990). In contrast, these children learn object-vocabulary relationships more easily at least when the trainer follows their attentional lead (P. Yoder, Kaiser, & Alpert, 1991; P. Yoder, Kaiser, Alpert, & Fischer, 1993). A more child-centered approach guarantees joint or shared reference, enhances semantic contingency, and reduces noncompliance by a child (McDade & Varnedoe, 1987). With semantic contingency, an adult comments on a child’s topic or previous utterance, thus facilitating processing by the child. Children appear to attend most to and be best able to comprehend speech during jointattention activities (Tomasello & Farrar, 1986). Responses to child actions or utterances provide contextual support (Duchan, 1997). Such support aids the processing of children with ID who have memory storage and retrieval problems that complicate encoding and decoding (Mervis, 1990). A child’s verbal behavior should be interpreted by others in terms of its possible intention, rather than viewed as inappropriate or incorrect. In other words, a request is still a request even though the form may be wrong, the item desired misnamed, and so on. When an adult has an agenda different from that of a child, the interaction is diminished. Such interactions are at cross-purposes and are faulty (Duchan, 1997). Children signal those things in which they are most interested by their actions or through verbalizations. This gauge can be used to keep child interest and motivation high in the intervention setting. Often, I will say to a child,“What toy do you want to play with?” Although the topic is open-ended, the technique is very specific—as we see later—permitting a flexible choice of topic. When a child initiates an interaction and is responded to accordingly, the value for learning is greater than when a child’s initiation is ignored or penalized (Duchan, 1984). Ignoring or penalizing a child will result in a decrease in future initiations. While observing a lesson in a training apartment in preparation for a young man’s move to his own apartment, I overheard the following exchange:

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SLP: What are you doing? Client: (Matter-of-factly) Dusting furniture. SLP: Good. What else are you doing? Client: You live in apartment? SLP: You didn’t answer my question. What . . . The client obviously was interested in living arrangements and would have joined such a conversation willingly if the SLP had followed his lead. The SLP should follow the client’s content and manipulate the conversation to encourage the desired language features. Continued use of directive responses by this SLP will diminish the client’s initiating behavior. ACTIVE I NVOLVE M E NT OF TH E CH I LD Language acquisition occurs with the active participation of the learner. Language learning is not a passive process. In like fashion, more rapid learning occurs when a child with LI is participating actively in some event. In general, the more actively involved the child, the greater and more stable the generalization. Ideally, intervention should consist of motivating participatory activities with the potential for a variety of language use contexts (Duchan, 1997). H EAVY I N FLU E NCE OF CONTEXT ON LANG UAG E Context can be a big determiner of what is said and how it is said. Language is a socially based cultural form whose use reflects an individual’s linguistic, interpersonal, and cultural competence within a given contextual situation (Rice, 1986). An individual’s knowledge of the event or situation influences the way he or she uses language in that situation. Language intervention should occur within the contexts of everyday events and within the context of conversational give-and-take or of other communication events. The language facilitator needs to create a rich context in which a child with LI can experience a variety of linguistic and nonlinguistic stimuli and be supported in his or her linguistic attempts. The integration of talking and listening within conversations should be emphasized. The content for these dialogues is the common experience of the intervention setting. Ideally, this setting reflects or is a part of a child’s everyday environment. The child and the facilitator talk about the focus of the activities used in training. The skillful facilitator can manipulate both the linguistic and nonlinguistic context to attain desired targets from the child. FAM I LIAR EVE NTS PROVI DI NG SCR I PTS A script is an internalized set of expectations about routine or repeated events organized in a temporalcausal sequence. As such, scripts contain shared event knowledge based on common experiences that aid and enhance memory and comprehension (Constable, 1986; Furman & Walden, 1989; Lucariello, Kyratzis, & Engel, 1986; K. Nelson, 1986). Scripts provide structure that describes appropriate sequences of events in particular contexts. Routinized events for which children have scripts provide specific situations in which children can learn appropriate language (Kim & Lombardino, 1991). Familiar activities of high interest, such as

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making popcorn, pudding, or cake, can be used as the contexts for language intervention. The event sequences contained in scripts can be used to teach language expression and comprehension and recall (Duchan, 1986b; 1997; Kim & Lombardino, 1991; Ross & Berg, 1990). Scripts have been used to improve both functional communication and group play among preschoolers (Neeley, Tipton, & Neeley, 1994). In addition, verbal routines and expansions have been linked to changes in MLU and generalization of language performance across different partners, contexts, and interactive styles (P. Yoder, Spruytenburg, Edwards, & Davies, 1995). Naturally, scripts will differ with a child’s maturational level and, to some extent, with the individual, although even very young preschoolers remember events in an organized manner similar to adults in general structure and content. As children mature, their scripts become longer, more detailed, and contain more options (“Sometimes . . .”), alternatives (“You either . . . or . . .), and conditions (“If . . . , then you . . .”) (Fivush & Slackman, 1986; K. Nelson, 1986; Slackman, Hudson, & Fivush, 1986). Individual differences may be the result of different experiences. In general, specific event experience is more important than age alone (Chi & Ceci, 1987; Ross, 1989; Ross & Berg, 1989). The resultant personal scripts are more important for memory than a vague generic notion (Ross & Berg, 1990). Individual experience becomes especially important when we consider intervention with CLD children. DESIG N I NG A G E N E RALIZATION PLAN FI R ST Considerations of generalization are essential to treatment program design and should be identified prior to beginning training. Table 9.2 is a suggested generalization plan format. In designing such a plan, an SLP considers the individual needs of the child and environment and the relevant variables that will affect generalization.

Generalization Variables To ensure generalization to the everyday environment of a child, the SLP must manipulate the generalization variables most likely to result in that outcome. The variables that affect generalization can be grouped as content and context variables (Table 1.2). Content variables include the training targets and training items. Context variables include the method of training, language facilitators, cues, contingencies, and location of training. Each of these variables and considerations for intervention as they relate to a functional model is discussed in this section, expanding on the brief presentation in Chapter 1. TRAI N I NG TARG ETS As mentioned previously, teaching the complex process of language use as discrete bits of language actually can retard growth. Language intervention should be relevant to the particular needs of a child within the communication environment and target the language process, rather than language products or units. Therefore, intervention must answer two questions (Warren, 1985): 1. What will be the function of the forms and content we are teaching? 2. Are the forms and content being trained in the context of communication events in which the intended function can actually be accomplished?

TABLE 9.2

Possible Generalization Plan Format

Training targets: Identify settings, situations, and persons across which training can occur. Settings: Situation:

P e r s o n s

Cues:

Consequences:

Situation:

Situation:

Situation:

Situation:

Situation:

Situation:

Situation:

Situation:

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In general, more frequently used targets are more relevant to a child’s world and, therefore, are more likely to generalize. Communicative utterances observed to occur in the home, albeit incorrectly, can be introduced in therapy as natural outcomes of the context. Once introduced, they can be modified by the facilitator. Language is usually acquired more rapidly and used more effectively if “communicative interaction” is established first (Rieke & Lewis, 1984). Language targets need to be those that increase the effectiveness of a child as a communicative partner. The first goal of intervention should be successful communication by a child at the present level of functioning. As mentioned, developmental guidelines can aid target selection but should be followed cautiously. Remember that a development “description” of normal acquisition is not a “prescription” for the way language must be taught (deVilliers & deVilliers, 1978). In forty-three published language-intervention studies, those that used goals approximating a developmental sequence were more successful that those that did not (Bryen & Joyce, 1985). In general, most earlier emerging forms can be learned in fewer trials and prior to later emerging forms. In addition, earlier emerging forms seem to generalize more readily into a child’s use system and at a higher level of use (Dyer, Santarcangelo, & Luce, 1987). A functional model would suggest teaching forms useful in the natural setting while attending to the developmental order of these forms (Dyer et al., 1987). Although the development of typical children can serve as a general guideline, the overriding criterion for target selection should be to aid the child in communicating what is necessary in the contexts in which she or he most frequently communicates. This practical approach is especially important for children who experience pragmatic difficulties, such as with TBI or psychiatric disorders (Audet & Hummel, 1990; Ben-Yishay, 1985; Russell, 1993). The best way to determine need is through environmental observation. If, for example, a child frequently requests items in the environment but is generally ineffective, then requesting might be chosen as a target. When there is very little opportunity for a possible training target to occur, it might be best to identify other content for training. Infrequent opportunity for possible training targets to occur may be the result of low environmental expectations or requirements for a child to produce these forms or functions. For example, there may be few opportunities for children to ask questions when there is little expectation that they will do so. In such cases, low expectations can become self-fulfilling. The communication environment may need to be restructured to facilitate use of newly acquired communication skills. An SLP should identify both targets and everyday situations in which each target is likely to occur and in which its use will be affected by and, in turn, affect the context. For example, questions should be trained in situations in which they make sense and in which they perform their intended function of gaining information. SLP instructions such as “I’m coloring a picture. Ask me what I’m doing” violate the function of questions. Usually, we do not ask questions for which we already have the answer. Similarly, an SLP’s attempt to elicit an answer with the instruction “What am I doing?” also violates the function of questions and answers. Although we might wonder about the mental capacity of SLPs who do not know what they are doing, we can modify both the situation and the cue to elicit an answer more appropriately. For example, the SLP might sit behind a screen, give clues, and ask the child, “Can you guess what I’m doing?” TRAI N I NG ITE MS An SLP should plan to train enough examples of the feature being targeted to enable a child to generalize to untrained members (Stremel-Campbell & Campbell, 1985). For example, it is neither desir-

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able nor possible to train all noun-verb combinations. The goal should be to train enough examples from the noun class in combination with examples of the verb class so that the child will generalize the rule noun + verb to all members of these two classes. Obviously, this process is being simplified in this discussion, and more planning and thought are required. In addition, a sufficient number of items must be trained so that a child can determine both the relevant and irrelevant aspects of the communication context. For example, words or phrases such as yesterday, last week, and in the past are relevant to use of the past tense. The child forms a hypothesis that states, “In the presence of yesterday, last week, or in the past, use the past tense.” Other aspects may be irrelevant, such as the specific nouns, pronouns, or verbs used. For example, the pronoun I is irrelevant and can be used with any tense. If the child is trained to use the form Yesterday, I . . . , Last week, I . . . , and In the past, I . . . , the resultant incorrect hypothesis might be “In the presence of I, use the past tense.” Knowledge of both the relevant and irrelevant aspects of the context are essential for learning. Not all word classes require the use of all training targets. For example, nouns do not take the past tense marker -ed, and tomorrow does not signal use of a past tense verb. A child needs to learn those response classes in which the target is required and those in which it is not. Initially, training response classes should be similar so as to limit irrelevant dimensions. For example, the child first may learn to use regular past tense with yesterday. Such words as today do not signal the tense as clearly and should be introduced later. Gradually, more irrelevant dimensions, such as longer sentences, are introduced. When a particular syntactic form or function is being targeted, it is especially important to select content words or utterances already in the child’s repertoire. With the targeting and introduction of new topic words, an SLP selects familiar structural frames. This principle is called “new forms–old content/old forms–new content” (J. MacDonald, 1985). Processing constraints found in all human beings reflect the limited capacity of the brain to process information. When these boundaries are reached, performance sacrifices or tradeoffs must occur in one area because of demands in another. For example, children omit more grammatical markers in longer, more complex sentences than in shorter, less complex ones (Nakayama, 1987). Children with LI are particularly susceptible to these constraints because the automatization of linguistic processing takes longer. Training items that exceed the information-processing constraints of these children may result in inadequate learning and poor generalization (J. Johnston, 1988a). Often a language feature fails to generalize because a child has not learned the conditions that govern its use. For example, if a child learns by imitation, he or she internalizes the variables that affect imitation, not the variables found in conversation. In order for a behavior to generalize to another context, such as conversation, the behavior must be related to the variables found in that context. Because a young child lacks metalinguistic awareness, rule explanation is not a viable clinical tool. An SLP must structure the environment so that linguistic regularities are obvious. Contrast training is one method of overcoming generalization problems (Connell, 1982). In contrast training, a child learns those structures and situations that obligate use from those that do not. For example, use of the third-person -s marker is required with singular nouns and third-person singular pronouns. A child must recognize also that plural nouns and other pronouns do not require this marker. Conversational use requires recognition of the linguistic contexts within which the training target does or does not appear. The identification of other contexts, such as events, facilitators, and settings, also should be accomplished. Using several different contexts ensures that a child does not identify the SLP and the therapy setting as the only contexts in which to use the language being trained.

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Ideally, functional training uses multiple examples (Stremel-Campbell & Campbell, 1985), such as the several categories of linguistic response classes or training items, several facilitators, and several settings. This feature is essential for generalization. M ETHOD OF TRAI N I NG In the past, language was taught much as one would teach any other complex behavior, and intervention centered on individual discrete behaviors. The goal was to increase the frequency of targeted language features. Language, however, is a set of rules that allow a person to use these language features in communication contexts to express intentions. A rule is an abstraction that describes similarities. Language is rule governed. Thus, the goal of intervention should be to learn the abstract rules, rather than the behaviors that reflect these rules. Many methods of teaching language do not reflect this goal (Connell, 1987b). There is a discrepancy between the goals and the methods of teaching. It is not practical with most children and most intervention targets simply to explain the language rule being trained. Instead, training needs to be limited to observations of the rule being applied within situations that contrast the critical conditions that apply to the rule (Connell, 1987b). For example, can you imagine trying to teach regular past tense to a child as follows: When a verb is used in the past, an -ed is added to it to produce a past tense verb, as in walk/walked. Instead, we might teach regular past tense in the following manner: Every day I walk, yesterday I walke d. Every day we talk, yesterday we talke d. The word yesterday tells us to add the /t/ sound. Now you try it. I’ll start. Every day I walk, yesterday I _____. Every day they rake, yesterday they _____. An SLP’s role is to provide organized language data to a child as an illustration of rule use. Thus, the child would be presented with paired minimally different situations that do and do not invoke the rule (Connell, 1987b). For example, these situations could be sentences in which the use of a form, such as pronouns, is alternately appropriate and inappropriate. Pronoun use might be contrasted with noun use. SLP: We’re going to play imagination. I’ll tell you about something in my mind and you try to find the picture. I’m thinking about a ghost. He has a big nose. Wow, you found that really fast. Okay, you think of something else. Child: It has blue eyes. SLP: I don’t know what you’re talking about. What’s the name of it? Child: A doll. SLP: Um-hm. What about the doll? Child: It has blue eyes. SLP: I found the doll with blue eyes. It’s easy when I know what you’re talking about. Try another. I’m thinking . . .

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Child: Thinking of a dinosaur and he’s got sharp teeth. SLP: Oh, I know which dinosaur has the sharp teeth. By presenting these contrasting situations and encouraging the child to practice, the SLP helps the child amass the data necessary to identify the critical elements of the rule. Once the child is aware of the critical elements, the SLP has the flexibility to present these elements in any communication situation. The strength of the rule-teaching approach is in the way it simplifies the learning task by condensing relevant input and highlighting critical conditions (Connell, 1987b). Unfortunately, not every form has a direct link to some function. The passive voice, for example, does not have a clear function and may be used to answer, comment, reply, declare, and so on. Forms that do not have a clear direct function are more difficult to teach. Rules based on abstract grammatical categories are also difficult. Functional techniques are effective because they incorporate behavioral principles and also use the context of naturally occurring conversations that can be modified systematically by the language facilitator. For example, the following exchange might occur with a child for whom we have targeted future tense. SLP: That sounds like fun. What about tomorrow? Child: Zoo? SLP: What about the zoo? Child: Go zoo. SLP: Now? Child: Go zoo tomorrow? SLP: You will? John will too, right. Tomorrow you both. . . Child: Will go zoo. SLP: I love the zoo. I wonder what will happen there. Generalization is more likely than with more structured approaches because the cues used resemble the varied ones found in communication events. In addition, the child’s attention is focused on objects and events in the environment while the child is receiving linguistic input about those objects and events (Warren & Kaiser, 1986a). A functional model provides a dynamic context for teaching language. Language training that works for a child in communication events should generalize to those events. The focus should not be merely the correctness of a child’s language, but its communicative potential (Bauer & Sapona, 1988). In general, functional intervention in combination with more structured remediation facilitates both acquisition and generalization of language targets to usage within natural environment situations. The functional approach involves (a) selecting appropriate language targets for a child and environment, (b) arranging the environment to increase the likelihood that a child will initiate, (c) responding to a child’s initiations with requests for elaboration of the target forms, and (d) reinforcing a child’s attempts with attention and access to objects in which the child has expressed interest (Warren & Kaiser, 1986b). Interactions between adults and children arise naturally in unstructured situations, such as play, and can be used systematically by the adult to give the child practice in communication. A child signals a potential topic by demonstrating interest or requesting assistance. Thus, the child provides the topic and the opportunity for the facilitator to teach the language form (Duchan, 1986b). The child is more likely to talk and be more interested in the content of this talk if the topic has been established by the child.

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Within these communication contexts, an SLP models the responses that fulfill a child’s communication goals. Because the purpose of language already is established in the natural environment, form and content may be learned more easily. In short, the child is taught a more effective way to communicate within a particular context (Audet & Hummel, 1990). The SLP also models behaviors for the caregivers in order to facilitate training and increase the likelihood that situations will occur in which the child is successful. When the desired interactions do not occur, the SLP can manipulate the environment to enhance its language-training potential (J. Norris & Hoffman, 1990a). Both linguistic and nonlinguist aspects of the context can be altered to elicit the desired communication. Activities can be planned around communication contexts that are highly likely to occur for the child. Training outside the normal environment should be as close to that environment in materials, situations, and persons as possible. Activities should include a child’s usual reasons for talking and typical topics, rely on previous experiences and introduce new ones, use familiar focuses of communication, and include the child’s normal communication partners (Spinelli & Terrell, 1984). Each child’s individual learning or cognitive style also must be considered by the SLP. Children are most comfortable with new experiences and information presented in a manner consistent with that style. In part, learning styles are culturally based, a consequence of accumulated experience (Saville-Troike, 1986; B. Terrell & Hale, 1992). For example, extended families, such as those in many Asian and Hispanic cultures, may foster a less independent style of learning than more nuclear families. Studies also have demonstrated that African American children benefit from incorporation of physical activity and movement into the learning situation (Hale-Benson, 1986, 1990a, 1990b). The SLP must recognize that events within a child’s everyday environments will differ in the amount of structure provided by the event itself (Duchan, 1986a). Some contexts are highly planned and scripted or routinized, such as bathing or eating, whereas others are relatively free and open, such as playing. The communication demands and the expectations on a child vary accordingly. Language intervention must recognize what a child brings to each context and what is demanded in return. New information should be organized to meet the functioning level of a child (J. Norris & Hoffman, 1990a). Routines may provide the best vehicle for training a child who is noninteractive. A child can ease into participating through repeated exposure to a routine in which the facilitator models actions and communication. Because the event is prescribed and expectations are known, there is some security for a child. Likewise, discussions of familiar events, such as a birthday party, provide a script for communicating. Routine event knowledge shared with a communication-facilitating adult provides the scaffolding for communication. Routines provide structure and expectations, freeing cognitive-processing abilities for linguistic processing (Lucariello, 1990). Overall, varied linguistic features are more likely to occur in familiar, meaningful contexts (Lucariello et al., 1986). Language treatment based on play and daily life experiences is similar to normal language-learning processes. By considering why and how children use words and gestures, an SLP increases his or her ability to provide the most natural and optimal situations for eliciting and teaching communication. The combination of appropriate context and specifically targeted language features facilitates maximum carryover and generalization outside the clinical environment (Kunze, Lockhart, Didow, & Caterson, 1983). Data from a number of studies indicate that functional intervention (a) teaches target skills effectively; (b) aids generalization to nontraining settings, times, and persons; and (c) improves both the formal and functional aspects of language (Warren & Kaiser, 1986b). The technique works well with a variety of age groups and populations with LI and with a variety of specific language responses. Lan-

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guage training generalizes to classroom and home settings and to teachers and parents. In addition, the general effects of the technique are beneficial to the overall language learning and functioning of the child (Rogers-Warren & Warren, 1985). LANG UAG E FACI LITATOR S If the goal is language use within a child’s everyday context, then a lone SLP working only in a clinical setting is limited as to what he or she can accomplish. The brevity of child–SLP contact necessitates the use of a wider variety of social contexts, including various communication partners. These partners supply a strong social base for intervention, providing a reason for language use (Paul, Looney, & Dahm, 1991). An SLP need not question whether these partners should be involved, but rather how they should be involved (Olswang & Bain, 1991). The appropriate partners to be used in training will vary with the age and circumstance of the child. Whereas parents may be appropriate for preschool children, they may have more limited interaction with their school-age children for whom teachers and peers may be more effectual. Successful use of the language taught in intervention programs depends, in part, on the expectations of these significant others in the child’s environment. Parents have been successful language facilitators with their children (Broen & Westman, 1990; Fey, Cleave, Long, & Hughes, 1993; Whitehurst et al., 1991). Most success has been reported for children in early stages of language and cognitive development (Girolametto, 1988; Tannock, Girolametto, & Siegel, 1992; Weistuch & Brown, 1987; Whitehurst et al., 1991; P. Yoder et al., 1991). For example, parents of children with ASD have been taught to provide intervention services within the daily routines of their preschool children at home (Kashinath, Woods, & Goldstein, 2006). Without intervention, is often difficult for toddlers with LI and their parents to establish mutually rewarding interactional patterns. Such children are less likely to succeed in a preschool setting. Their experience level and their success in communicative interaction are often minimal, and they may exhibit poor listening skills. Children who are not successful in communication often become resistant or negative and develop attention-getting behaviors. A child must have the opportunity to communicate; thus, a facilitator must be attentive and responsive. A facilitator must consistently recognize a child’s attempts to communicate and provide appropriate responses (Wilcox, Kouri, & Caswell, 1990). Parents need to be taught more than just modeling language and their progress as trainers must be monitored (Fey, Cleave, & Long, 1997). Communication partners, such as teachers and parents, can be an effective part of an intervention team if they are trained and monitored thoroughly (Jimenez & Iseyama, 1987). A facilitator must be trained in both (a) the how, or the best teaching techniques, and (b) the what, or the goals and materials for intervention. Training of facilitators can be accomplished in a combination of ways, including direct training and modeling, in-service training, and the use of telephoned and written/illustrated instructions. To provide effective intervention services at home, parents need realistic input. For example, training might include user-friendly written handouts explaining the teaching strategy and/or target, video-recorded and live demonstrations, practice and critique, and discussion. Caregiver Conversational Style According to the interactional model in this text, the difficulties experienced by children with LI reflect their everyday contexts as much as their so-called disorder. If this is so, then conversational partners must assume some of the responsibility for the communication of these children. For example,

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although adult interaction-promoting strategies, such as extended conversations and questions to promote turn taking, are positively related to language productivity in preschool children, adults in childcare centers are more responsive to the context of interactions than to the language abilities of preschool children (Girolametto & Weitzman, 2002). If we want change to occur, we need to change adult behaviors. The quality and quantity of spontaneous conversational behavior of children with LI are negatively related to the number of verbal initiations and directives by their adult conversational partners. Partially in response to these children’s language deficits, adults modify their own language. Mothers of children with LI repeat more than do mothers of children developing typically. Most of these maternal repetitions are imperatives (demands) or directives (commands). The frequency of these parental directions and of self-imitations is negatively correlated with the rate of a child’s language growth. In a highly directive interaction style there is often no connection between the directive and any utterance of the child. Adult verbal control of interactions also seems to affect adversely the verbal output of children with LI. For example, although the question-answer style of adult communication may aid children functioning around age 2 to maintain a conversational topic, it can discourage children from commenting outside the topics initiated by the adults (Mirenda & Donnellan, 1986). As children with disabilities and those without move beyond this developmental level, the use of a question-answer strategy is counterproductive to the goal of spontaneous conversational behavior. An adult directive style includes verbal conversational behaviors that (a) control and initiate conversational topics, (b) lead the conversation, and (c) structure the nature of the child’s contribution (Mirenda & Donnellan, 1986). These behaviors ensure a cohesive and fluent conversation at the expense of the child’s spontaneous initiations. In contrast, the use of an adult facilitative style of conversation can increase the use of topic initiations, questions, and topic comments by children with LI (Mirenda & Donnellan, 1986). An adult facilitative style (a) allows a child to control and initiate conversational topics, (b) follows a child’s conversational lead, and (c) encourages a child to participate in various ways. A facilitative adult is less interested in conversational flow than in providing an opportunity for a child to participate and to assume control of the conversation. Specific behaviors that define each style are given in Table 9.3. Several conversationally based parent-training programs have demonstrated an increase in parent responsiveness and a decrease in directiveness toward their preschool children with LI (Broen & Westman, 1990; Mahoney & Powell, 1986; Weistuch & Lewis, 1986). Other changes include increased willingness to follow their child’s lead, more equality in turn balancing, shorter parental MLU, and fewer questions. Mothers who receive facilitative training are more responsive to and less directive of their children’s behavior than are untrained mothers (Girolametto, 1988). These changes in parental behavior are related to such child language changes as increased MLU, increased number of utterances, increased lexicon, and improved standardized test scores. Children whose parents receive training initiate more topics, are more responsive, use more verbal turns, and have a more diverse vocabulary. These results suggest that the effect of parental conversational strategies may be greater on semantics and pragmatics than on linguistic form. An increase in the percentage of semantically related or contingent utterances can, in turn, provide greater opportunity for topic maintenance and turn taking. With more opportunity to participate, the child gains more control over both the adult’s behavior and the exchange process.

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Characteristics of the Directive and Facilitative Styles

Directive

Facilitative

Initiate at least half of the topics of conversation.

Initiate fewer than half of the topics of conversation.

Use direct questions to initiate most topics.

Use indirect questions or embedded imperatives to initiate most topics.

Use primarily direct questions and occasional imitations or expansions to maintain topics.

Use primarily direct statements, encouragements, imitations, expansions, or expansion questions and occasional direct questions to maintain topics.

Do not ask for clarification directly, relying instead on encouragement, imitation, and expansion strategies.

Use direct clarification questions or statements when necessary and appropriate.

Do not allow lapses in turn taking to occur, but use direct questions to require the child to respond.

Allow lapses between turns to occur and after a short wait, initiate topics as noted above.

Children’s spontaneous verbalizations can be enhanced when adult facilitators provide a high level of verbal feedback coupled with little verbal directing (Broen & Westman, 1990). Examples are given in Table 9.4. Data from several studies suggest that children’s conversational abilities can be increased by adult behaviors that are highly responsive to a children’s spontaneous communicative behaviors. Language facilitators plan their role in the communication event and their communication turns to maximize the learning opportunity for a child. Within each turn, the facilitator responds to the child while troubleshooting the child’s previous utterance, maintains the conversation by taking a meaningful turn, and provides an opportunity for the child to respond (see Table 9.4) (Craig, 1983). The use of parents, teachers, and others as language facilitators does not diminish the role of an SLP. It is essential that he or she remain very involved in the intervention and also become a facilitator. Whereas parents sometimes find it difficult to adapt their behavior to a more facilitative style, SLPs TABLE 9.4

Examples of Minimally Directive Verbal Feedback to Children

Child: I went to the zoo, yesterday. Partner: Oh, that’s one of my favorite spots. I love the monkeys best. Child: I have a birthday party, tomorrow. Partner: Oh, that should be fun. What do you want for your birthday? Child: We went whale watching on vacation. Partner: I’ve always wanted to do that. Bet it was exciting. Tell me about it. Child: My picture is a cowboy. Partner: A big cowboy on a spotted horse. Child: I’m gonna be a ghost for Halloween. Partner: Don’t come to my house; I’m afraid of ghosts. I think I’ll be a witch and scare your ghost. Note: In each of these five exchanges, the adult followed the child’s lead by commenting on the child’s topic and then cueing the child to provide more information or waiting for a reply.

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TABLE 9.5

Guidelines for Implementing a Family-Centered Collaborative Model

Define your role and explain your approach to intervention. Convey respect by 1. 2. 3. 4. 5. 6. 7. 8. 9.

Providing real choices for the family and encouraging them to make decisions Providing requested information and services immediately Ensuring confidentiality Recognizing cultural/ethnic values, traditions, and beliefs Explaining the purposes of procedures and methods Providing a rationale for procedures and methods Ensuring a role for the family in both assessment and intervention Meeting at times and locations convenient for the family Attending to family concerns before professional concerns

Ensure that the family attends all discussions and decision-making meetings. Use language that can be comprehended easily by the family. Speak to family members forthrightly, completely, honestly, and in an unbiased manner. Design intervention plans to fit the family’s routine. Be flexible in intervention planning. Source: Adapted from Crais (1992); B. Johnson, McGonigel, & Kaufmann (1989); McWilliams & Winton (1990).

can more readily provide this input on a consistent and uniform basis (Fey et al., 1993). Best results seem to occur when other facilitators receive frequent, regular, structured training, including roleplaying and critiques. Family-Centered Intervention There is a distinct difference between parental involvement and family-centered or family-focused services in which all family members participate (Crais, 1991). Public Law 99-457, regarding education of special needs populations, focuses on the family as integral to intervention. In a family-centered model, families are treated as valued, equal partners and are encouraged to participate at all stages of decision making. Families are recognized as a constant in a child’s life, while special services are recognized as more transient by nature. In such an arrangement, the SLP–family relationship becomes a collaborative one. The aspects of this collaborative model are presented in Table 9.5. Although each family is individualistic, culture is one of the most important influences on it, affecting such aspects as structure, interaction, function, and life cycle. Family structure includes the number of individuals and types of relationships, but more important, the cultural values and beliefs about family structure. Family interaction is the way family members relate and the roles they play within the family. The relative importance of certain roles will vary with the culture. For example, a child who is an unmarried adult will be treated very differently, depending on the family background. Interactions are governed by the cohesion of the family, its adaptability or ability to change, and patterns of communication (Summers, Brotherson, & Turnbull, 1988). Family functions are the responsibilities that families are expected to assume for their members. Again, this aspect of families varies widely across cultures. Some cultures may value overprotection of children more than an SLP’s goal of increased independence.

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Finally, family life cycle describes the changes in families over the course of their development. Nuclear families may have periods of isolation after children have grown or in old age, whereas extended families may not experience this phenomenon. With infants, toddlers, and preschool children, an SLP is required to design an Individualized Family Service Plan (IFSP) for the child and family. The IFSP is a plan for service, not for treatment alone, and represents a team effort that includes the family (Polmanteer & Turbiville, 2000). The origin of family-centered services is in functional theories such as those espoused in this text. A child is seen as an individual within complex relationships that are affected by the child and affect the child in return. An SLP has a perspective from which he or she views the child. Members of the family offer differing perspectives. These diverse points of view can offer insight into the communication of the child and help to explain her or his behavior. If families are going to be the vehicles for change, an SLP must try to understand each family’s perceptions, feelings, concerns, and understanding of their child with LI (Polmanteer & Turbiville, 2000). IFSP recommended practices are presented in Table 9.6. Families and Children from CLD Backgrounds Cultural identity is not a stereotype. Families within the same culture differ. Recognition of cultural contributions by an SLP, however, increase the likelihood of appropriate and effective intervention. Table 9.7 presents guidelines for SLPs to follow when interacting with culturally diverse families. SLPs should be mindful of the differing expectations and perceptions of various ethnic and racial minorities. The role of parents, the expectations for children, and the attitudes toward disability, medicine, healing, self-help, and professional intervention within a minority population should be understood thoroughly prior to intervention. For example, mothers from Puerto Rico who live on the mainland seem to hold beliefs about early education and literacy that reflect both their original TABLE 9.6 (IFSP)

Recommended Practices for Implementing Individualized Family Service Plans

Team members include family members and selected members of the family’s informal network of friends, neighbors, and other service providers, plus professionals such as the SLP. Community and culture must be considered in assessment and intervention. Family members sign the IFSP. Family members’ assessments of the child’s skills are included in reports and in the IFSP. Family members provide information on the child’s communication and communication partners. Of interest are the language(s) used, stylistic variations, roles, modes of communication, and adult expectations and teaching style. IFSP outcomes Are written in the family’s language and avoid professional jargon. Reflect the family’s concerns and priorities shared by the team. Reflect beneficial changes identified by the family. Services are provided by multiple agencies listed on the service plan in settings that are typical for the child’s age peers who have no language impairment. Source: Adapted from Polmanteer & Turbiville (2000); Scheffner Hammer (1998).

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TABLE 9.7

Guidelines for Interacting with Culturally Diverse Families

Do not make assumptions based on cultural stereotypes. Cultural rules govern each encounter for both the family/child and the speech-language pathologist. Be aware that responses to stimuli, such as a clinic room, may be very different across cultures. Learn about the cultures of the families and the children you serve. Use cultural mediators or interpreters when necessary. Learn to use words, phrases, and greetings from the culture of the family/child. Be patient; allow more time for interactions. Use as few written instructions as possible, unless a family member has good English reading comprehension. Allow time for questions. Recognize that the family may not be prepared for the amount of professional-family collaboration found in functional approaches. Encourage family input without embarrassing family members. Involve the family to the extent that they wish to be involved. Ensure that goals and objectives of the professionals and the family match. Involve the cultural community when possible. Source: Adapted from Lynch & Hanson (1992); Wayman, Lynch, & Hanson (1990).

culture and more North American notions (Hammer, Rodriguez, Lawrence, Miccio 2007). Children and professional intervention services are viewed quite differently across Asian, Hispanic, and African American cultures. Likewise, an SLP’s conversational style may have a great effect on future involvement with members of that community (Matsuda, 1989). Successful SLP–family collaboration should be characterized by mutual respect, trust, and open communication (Wayman et al., 1990). These characteristics only evolve when an SLP is sensitive to the cultural background of the families with whom he or she interacts. Although I have tried to make the teaching techniques mentioned in the next chapter culture-free, the model of intervention proposed in this text is based primarily on North American psycholinguistic research of white, middle-class families and, therefore, contains an implicit cultural bias (van Kleeck, 1994). The use of these techniques with parents and children from CLD backgrounds is not cultureneutral. When we ask mothers to use these techniques at home, we need to be very sensitive to cultural differences that define how parent–child interactions occur (Johnston & Wong, 2002). These interactions reflect cultural beliefs about the roles of parents and children and the ways in which language is learned. For example, children may be expected to be quiet and not to speak. In the reverse situation, a toddler’s lack of comprehension may be justification for a parent’s speaking infrequently with a child. An SLP must determine these cultural belief systems and modify intervention techniques accordingly. Otherwise, intervention may be less effective, or worse, parents may actively resist intervention efforts. Information can be gleaned from reading research studies, talking with community representatives, and working closely with parents. One caution: Anthropological studies may describe broad national beliefs while glossing over local differences or may do the reverse, studying one unique community within a larger culture. Nothing beats getting involved with the cultural community, attending religious services, clubs, and festivals, and talking with and listening to parents and community members. An SLP also cannot make assumptions based on catch words or oversimplifications. Let me give you one example from my own experience. I have been to South Korea twice. Approximately 40 per-

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cent of the population there—and over 95 percent of Korean immigrants to the United States—are Christian, mostly in the big cities, such as Seoul. This fact is not exactly what it might seem to most U.S. citizens. These same believers also follow Buddhist and Confucian precepts, such as ancestor worship, deference to older people, order, and societal interdependence. Indeed, Korea is known as The Land of Morning Calm, a non-Christian Korea. At the same time, various Korean Christian denominations tend to be very myopic by our more inclusive standards, often considering other denominations not to be Christian. For example, Catholics may be referred to as non-Christian by Methodists, and the reverse. To place Western Christian notions into this context may result in misunderstanding. Your hometown version of Presbyterianism may look very different in a Korean context. Once we enter someone else’s culture, many of our assumptions must be set aside. Even when things seem similar, they may not be. If this feels a bit like Through the Looking-Glass, and What Alice Found There (1871), Lewis Carroll’s classic children’s book, you are not far from wrong. Things sometimes move in different directions than we expect. Let’s use Chinese culture as an example and explore the implications for intervention (Johnston & Wong, 2002). Based on research literature, we can make the following broad characterizations of Chinese cultural beliefs: ideal self is embedded in interdependent social relations, requiring obedience and respect of • The others over self-fulfillment and independence. behavior is very malleable rather than biologically based. • Human When a child goes to school, he or she passes from a period of nonunderstanding to one of under• standing in which the child can be expected to succeed. As a result, parents are less likely to join preschool children in play or to engage them in social communication. Instead, parents are more directive, focusing or refocusing a child’s attention. These beliefs impact intervention in myriad ways. For example, a parent may not understand our insistence on the importance of early intervention. Any discussion of this topic must include the importance of early intervention for later success in school, a Chinese cultural value. Similarly, the notion of following a child’s lead does not flow naturally from beliefs in interdependence and the nonunderstanding of young children. It might be better to help Chinese mothers construct more formal teaching lessons to be used several times each day within the home (Johnston & Wong, 2002). Note that the use of the home environment still retains the basic functional nature of intervention. Given differences in cultural beliefs, there are likely to be occasions when well-intentioned intervention recommendations run counter to cultural expectations of the family you serve. To be successful, an SLP must find “functional equivalents” that achieve the same ends (Johnston & Wong, 2002). For example, parents of young children with LI are often encouraged to engage in book-sharing activities. The goal is social communication, not book reading per se. Other methods can be found that attain the same goal while being more culturally appropriate to the child and family, such as oral storytelling. For my money, this is one of the best aspects of our profession: problem solving and finding intervention methods that work for each individual child and family. Language is one of the primary modes of socialization and acculturation for children. When a child learns a second language, such as English, in an English-intensive educational program, he or she is in danger of losing the first language. This may be especially true for children with LI who receive remedial intervention for English but no help with their initial language in which they are most likely also impaired. Given the interdependence of emotional, cognitive, and communication development in young children and the needs these children have for family support, it is important that SLPs also

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support the home language of these children (Kohnert, Yim, Nett, Kan, & Duran 2005). This does not necessitate intervention in both languages. Potentially, well-trained parents can be as effective as SLPs in administering intervention (Law, Garrett, & Nye, 2004). As mentioned, an SLP can directly train a parent who then becomes the primary intervention agent for the child. Successful parent training requires the following (Bailey, Buysee, Edmondson, & Smith, 1992): language facilitation strategies vs. general stimulation • Specific Use of multiple sessions and instructional methods with parents • Systematic progression skills • Activities tailored for theofindividual child • Rather than suggest that parents cease using one language at home—a huge imposition, especially for families that freely mix languages—it seems best to target activities, such a book reading, in which one language would be used exclusively. Where necessary, it may be helpful to use paraprofessionals from the language community or siblings as in-home trainers. TRAI N I NG CU ES If one accepts the premise that pragmatics is the governing aspect of language, then an SLP must be concerned with the context within which training occurs. Certain linguistic and nonlinguistic contexts require or provide an expectation of certain linguistic units. In part, the problem of lack of success in generalization is due to response programs “in which children are taught specific responses to specific, often carefully worded, directions or questions” (Rieke & Lewis, 1984, p. 49). A child’s everyday world lacks this careful control. The everyday context contains many irrelevant stimuli that do not and cannot elicit trained communication behaviors. At the same time, parents and teachers may be presenting cues and prompts in such a diverse manner as to inhibit learning. They can be trained to focus their attention and to manipulate the environment to elicit the behaviors desired (Lucariello, 1990). Within an approach in which conversational partners respond to all communication attempts by a child and prompt additional presponses, an increase in the number of child utterances and vocabulary is associated with increased talking and the use of questions by an adult (Kaiser & Hester, 1994). Too often, the traditional approaches rely on very narrow and somewhat stilted cues unlike those found in conversation. The use of these traditional cues, such as “Tell me the whole thing,” may result in training characterized as “apragmatic pseudoconversational drills” (Cochrane, 1983). Pragmatically, the cues do not make sense—for example, asking a question to which the speaker already knows the answer. As a result, the conversations within which training occurs are little more than drill with a conversational veneer. Verbal and nonverbal cues can be varied to ensure that the child does not become dependent on one stereotypic stimulus. A system of least prompts can be used, in which an SLP rates each type of prompt from least to most intrusive and supportive (Timler, Vogler-Elias, & McGill, 2007). Through the course of intervention, the SLP works to minimize prompting whenever possible and to allow the context to prompt the targeted language features. For example, children with ASD can be taught to initiate requests and to make comments through a system of decreasing prompts, moving from sentence completion (Can I . . .) through questioning (What could you ask your friend?) to pointing to a similar written phrase (Thiemann & Goldstein, 2004).

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Relevant, common stimuli within the everyday communication context can serve to elicit a child’s new language targets if these stimuli are included in the training (Stremel-Campbell & Campbell, 1985). Targets can be trained across several behaviors, facilitators, and settings to ensure generalization. For example, a child’s toys or everyday items and daily routines become part of the training. The systematic introduction of increasingly more irrelevant stimuli from the communication environment into the training context has been termed “loose” training (Stremel-Campbell & Campbell, 1985). The overall goals are for the newly trained behavior to be emitted in response to a variety of stimuli and for a single stimuli to result in a variety of responses. These goals can be achieved by using concurrent behaviors, response variations, and linguistic and nonlinguistic cue variations. In concurrent behavior training, relevant and irrelevant stimuli are presented together so that a child learns which ones affect the newly learned behavior. Response variation teaches a child that several responses can be used to achieve the same communication goal. For example, a drink can be attained by saying,“Want drink,”“Drink please,”“May I have a drink?” “I’m thirsty,” and, “Are you as thirsty as I am?” Use of a functional conversational approach requires an SLP to assess thoroughly the effects of certain cues and to explore the possibilities of eliciting language with a variety of linguistic and nonlinguistic cues (Constable, 1983). Those SLPs who rely on traditional cues are unaware of the rich variety of cues available for creating contexts in which language targets can occur. CONTI NG E NCI ES Once a language facilitator has elicited language from a child in a conversational manner or a child has initiated language, the facilitator can begin to modify that language if necessary. In short, the child’s utterance is the stimulus to which the facilitator responds. These responses or contingencies help form the context for the child’s utterance. Natural maintaining consequences should be identified prior to beginning training. As much as possible, these consequences should be related directly to the response. Such consequences as “Very good” and “Good talking” should be avoided (Stremel-Campbell & Campbell, 1985). When a child message (“I saw monkeys”) and the consequence (“Good talking”) are unrelated, the child’s language fails to retain its communicative value. Communication behaviors can be maintained by conversational responses (“Oh, I think monkeys are funny. What did they do?”). Often, simply attending to a child is sufficient to maintain the child’s participation. As much as possible, conversational consequences should be semantically and pragmatically contingent and should serve to acknowledge a child’s utterance. Semantic contingency, the relatedness of a parent’s or facilitator’s response to the content or topic of a child’s previous utterance, has a positive effect on the rate of language development. In the above example, “I saw monkeys,” the adult response is semantically contingent. Adult speech that is semantically contingent decreases the amount of processing a child has to do to understand and analyze the structure and meaning of an adult’s utterances. The sharing of a conversational topic and common vocabulary decreases a child’s memory load for processing and increases the ease of immediate language production. The facilitator’s utterance provides a prop or scaffolding for the child’s own analysis and production. For children with expressive vocabulary delays, the semantic contingency of adult responses has more effect on a child’s language than does the structure of the adult response (Girolametto, Weitzman, Wiigs, & Steig Pierce, 1999). In contrast, frequent topic changing or refocusing of a child’s attention by an adult impedes the child’s language acquisition.

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It is not enough, however, just to comment on a child’s topic. In the following example, the facilitator’s response is semantically contingent but lacks pragmatic contingency. Child: I want cookie, please. Facilitator: Johnny wants a cookie. The facilitator’s response should make sense within the conversational framework. In this example, more appropriate responses would be,“What kind of cookie do you want?”“Okay, but just one,”“Help yourself,” and, “No cookies until after lunch.” This example shows why contingencies such as “Good talking” violate pragmatic contingency and do not help continue the interchange. The child’s language is reinforced more naturally when its purpose and intention are met. In brief, behaviors that attempt to increase a child’s participation in the interaction, that is, a childcentered interactional style, enhance a child’s language skills. By relinquishing some control and adopting the child’s topics, language facilitators can ensure more child participation and interest. Overall, in the clinical setting it is important that facilitators accept a child’s utterance as representative of the child’s understanding of the world and of the requirements being asked. Answers considered wrong by the adult may, in fact, represent a child’s somewhat different perspective. A child’s meaning can be negotiated by the facilitator and the child as the conversation continues. LOCATION As noted in Chapter 1, location of training includes both the physical location in which training occurs and the conversational context formed by a child and a facilitator. In many ways, the conversational context is more important for generalization because it does not depend on physical setting and transcends the clinic, classroom, and home (J. Johnston, 1988a). In the light of the flexibility of these natural communication sequences, training is more a matter of how than where (Craig, 1983). Physical Location When possible, training should occur wherever a child is likely to use the newly trained language skill. Most communication takes place within familiar events that influence the way the participants communicate. For example, storytelling, conversation, and classroom participation have different rules for participation. Therefore, language intervention should take place within these types of discourse events and others as they occur in a child’s everyday physical locations. The everyday environment provides natural and familiar stimuli for intervention and for generalization (Caro & Snell, 1989). Children with lingering pragmatic deficits, such as those with TBI, are particularly in need of environmentally based intervention (Russell, 1993). Obviously, parents and teachers will need to be trained for their new roles as language facilitators. Parents may come to a clinic or school to be trained. If this is not possible, evening group sessions or written guidelines can be used. Even if parents only modify their expectations for the child, this will help with the generalization of language training. Conversational Context Language must be evaluated and trained within some dynamic context in order to make sense. Language and communication are influenced heavily by the context of what precedes and follows (linguis-

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tically and nonlinguistically) and by the expectations for participation with that specific context. For example, the expectations for storytelling are different from those for conversation. Ordering at a fastfood restaurant presents different expectations from chatting with a friend on the phone. Each event follows certain scripts. Sentences trained out of context are, therefore, more difficult for a child to learn. SLPs are not training static forms but a generative, versatile system. The contextual expectations and scripts must be examined prior to beginning intervention within each context. Conversations provide a dynamic context in which language serves a purpose or function. Although these conversational sequences may mirror natural sequences, the SLP and other language facilitators are mindful of the teaching potential (Craig, 1983). Communication strategies can be provided to the child as needed (Spinelli & Terrell, 1984). Teaching approaches can be adapted to this setting to approximate more closely conversational exchange.

Conclusion By carefully considering the variables that affect generalization, an SLP can modify training to maximize this effect. Targets and design decisions can be made on the basis of the likely effect on generalization and on ultimate use within the events and situations of a child’s everyday environment. Language can be elicited and modified by using techniques that mirror the conversational style used by a child’s usual partners within these contexts. Motivation is provided by a child’s desire to participate in enjoyable activities with responsive and attentive adults. Facilitators should adhere to the following guidelines: 1. 2. 3. 4. 5.

Expect the child to communicate. Respond to the child’s topics and initiations. Respond conversationally and build the child’s utterances into longer, more acceptable ones. Facilitate communication within the everyday activities of the child. Cue the child in a conversational manner to elicit the language desired.

All of these principles are discussed in Chapter 10.

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L

anguage is pragmatically based. The demands of the nonlinguistic and linguistic context give rise to both the form and content of the language expressed. Therefore, a primary goal of language intervention should be for a child to learn the appropriate language skills to function effectively within everyday communication contexts or environments. Within each activity, a language facilitator strives to provide an active experience with language use. It seems appropriate, then, that the SLP and other language facilitators learn to manipulate these contexts to provide a child the maximum learning possible. A facilitator’s role is “to accept the child’s spontaneously occurring verbal or nonverbal behavior as meaningful communication, interpret it in a manner that is contextually appropriate, and become a collaborator with the child in communicating the message more effectively” (J. Norris & Hoffman, 1990b, p. 78). When language can be used to achieve goals within everyday communication contexts, the chances of generalization to these contexts increases. Language acquires a purpose or function. The training becomes functional in nature. In this chapter we explore various strategies that can be used to manipulate the nonlinguistic and linguistic contexts in which language occurs. These strategies can be used within the everyday activities of a child and, thus, can become a part of that natural environment. As much as possible, natural and conversational strategies are recommended.

Nonlinguistic Contexts Speech-language pathology is so oriented toward linguistic forms of communication that it is easy to overlook the nonlinguistic aspects. Yet, the nonlinguistic context—what happens in the environment— offers a rich source for eliciting language. An SLP can manipulate the nonlinguistic contextual cues to elicit desired language and to ensure that a child initiates language. All too often, the training paradigm of a child with LI allows the child little control. Therefore, the child assumes a passive, responsive role. Certain nonlinguistic contexts naturally elicit more language than do others. For most adults, cocktail parties are more likely to elicit language than are theater engagements. Inherent in the theater experience is the necessity to remain silent during the performance. Some situations also dictate the type of language used. Most adults do not question and challenge sermons—at least not while the sermon is being delivered. In contrast, learning situations, such as in a classroom, are supposed to encourage questioning. If targets have been selected to help a child communicate better, then an SLP already has identified the contexts in which the child attempts these targets. In other words, the nonlinguistic contexts that are highly likely to elicit the target are known. Ideally, the nonlinguistic context serves to elicit the target language behavior: The SLP then can help the child modify the target into a correct form for that situation. In theory—and this is key to our success—a child who makes a meaningful response in context will be interested in that response and motivated to change it in the desired manner. This corrected response should generalize more easily to everyday use because it is being trained within the context of everyday events and conversations. Table 10.1 contains a sample of nonlinguistic contexts and the type of language each may elicit. Small group projects or tasks usually elicit lots of language from children. For younger children, roleplay and dress-up are good contexts for language. Routines also can be established within the home or the classroom for asking for desired objects or privileges.

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TABLE 10.1

Nonlinguistic Contexts and Language Elicitation

Turn taking and requesting objects: Provide only one plastic knife for children to share as they make a fruit salad. Provide one highly desirable outfit in the dress-up corner of the class. Provide only enough art supplies for half of the children and request that children share equipment. Following directions and directing others: While working in a group, re-create the teacher’s construction-paper collage. The teacher should be careful not to supply precut paper or to help children with the color tints. The goal is to get the children to ask for help and to direct others and themselves. In groups of two, duplicate a cake decoration previously completed by the teacher. As a group, plant seeds in cups as the teacher has done previously. A more involved project might involve planting a garden, keeping the different crops straight, and making signs. Bake while following a written or pictured recipe. Put together a model by following written or oral directions. Play dumb. By making lots of mistakes, the teacher can have children direct or correct the behavior. Have a child explain how to do something known by only that child. Have children direct each other through activities blindfolded. Have the child be the teacher. Requesting information: Give only partial directions for completing a task. Put objects that the children need for a task in an unusual location so that they will need to ask for the location. Introduce visually interesting items but do not name them or explain their function to the children. Giving information: Have children explain class projects to children from another class. Have children explain class projects to parents at a special event or Parents’ Night. Have children tell about events they experienced: for example, summer vacation, a weekend trip, a birthday party. This task and explaining how something is accomplished are excellent vehicles for sequencing. Have children request information from children who need to improve their ability to give information. Have children tell make-believe stories. Reasoning: Have children try to float or submerge objects in water. Include objects that float and those that do not so that the children must find various combinations. Build a suspension bridge from straws, string, toothpicks, and tongue depressors. Design a city with transportation, schools, recreation facilities, and residential, industrial, and business areas. Play initiative games in which groups of children must solve a common problem. Make large projects in connection with class projects. For example, children might design the “perfect” world, make montages that demonstrate male and female roles, or design a board game, such as On the Way to Your Birthday, that illustrates stages of fetal development. Requesting help: Pose problems that children cannot solve themselves. Sabotage activities, such as holes in paper cups, dried markers and paints, glue bottles glued shut, not enough chairs, missing gloves and hats, and so on. The list is endless. Imagining and projecting: Set up a drama or dress-up center. Set up a puppet stage with a variety of characters.

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Set up simulated shops and stores or a housekeeping center. Role-play. (Role-play can elicit a variety of intentions.) Protesting: Play dumb, as in forgetting to give children peanut butter and jelly with which to make sandwiches. Miss a child’s turn or withhold needed objects. Violate a routine or an object function by using objects in novel or nonsensical ways. Give a child too much of something or more than is needed. Put away objects before the child is finished using them. Ask a child to do something that is not physically possible (but safe). Initiations: Pose problems and wait for children to initiate communication. Ask children to talk to lonely animals for you. Source: Author’s experience; Constable (1983); Kunze, Lockhart, Didow, & Caterson (1983); Staab (1983).

Within these nonlinguistic contexts, language may be elicited through the use of delays, introduction of novel elements, oversight, and sabotage (McLean & Snyder-McLean, 1988b). Delaying or waiting for a child to initiate communication is often a very effective strategy, especially after a child has mastered a desired behavior (Hart, 1985). Too frequently, adults do not expect a child to communicate, and this expectation becomes self-fulfilling when the adult communicates for the child. Let’s assume that the language facilitator is waiting for a child to initiate the interaction. The facilitator may sit near the child and look questioningly or display some interesting item while looking at the child (Hart, 1985). When the child looks at the adult, the adult does not speak for a specified period of time unless the child does. If the child does not verbalize, the adult models or prompts the desired verbalization. Novel or unexpected events can be introduced into a situation to evoke communication. Most individuals will notice and remark on such events. For example, a kitten, guinea pig, or bright toy might be found in an unexpected spot. Even children functioning at the single-word level will comment on elements in a situation that are novel, different, or changing. Oversight or forgetting by a facilitator will elicit language from a child who’s eager to become the teacher. I often play dumb, forgetting object locations or children’s turns. Needed objects, such as glue or scissors, can be omitted or used in unusual ways. Finally, sabotage of activities or routines involves taking actions or introducing elements that will not permit the activity to continue or to be completed (Constable, 1983; Lucas, 1980). My favorite example is the classroom teacher and aide who would buckle the children’s boots together and turn their coats inside out sometime during the day. One can imagine the chaos at the end of the day and all of the language elicited as children requested assistance.

Linguistic Contexts The goal of language use within a conversational context necessitates a thorough evaluation of the linguistic cues used with children in the training situation. Cues such as “What do we say?” and “Now, tell me the whole thing” are examples of pseudoconversational cues mentioned previously.

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Eliciting language through constant prodding or interrogation can be unpleasant and actually result in less talking by the child. Such communication is one-sided, with the child assuming the role of receiver or occasional reluctant speaker (McDade & Varnedoe, 1987). Linguistic contexts can be divided into those that model language with or without a child’s response, those that directly and indirectly cue certain responses, and those that do not cue these responses. A particular utterance may cue one type of behavior but not others. MODE LI NG In comparative studies, the efficacy of the modeling approach has been demonstrated repeatedly. Modeling is a procedure in which an SLP produces a rule-governed utterance at appropriate junctures in conversation or activities but does not ask the child to imitate. The technique compares favorably with more active techniques, such as question-answer, that require responses by a child (Weismer & Murray-Branch, 1989). Modeling can be used in any of the following ways: 1. As a high-frequency response in very structured situations 2. As general language stimulation containing a number of language targets simultaneously 3. As an element in comprehension training in which a child points to pictures that illustrate the utterance modeled In general, modeling closely approximates the language-learning environment of children developing typically and is an effective language-learning strategy for a child with LI. It is expected that the child will acquire some aspect of the language behavior of the facilitator and use it in a similar context later. Unlike direct instruction techniques, interactive modeling considers the child to be an active learner who abstracts the rules used in forming utterances and associates these utterances with events and stimuli in the environment. It is best to model the training target for a child prior to attempting to elicit the target. Within such focused stimulation, an SLP produces a high density of the targets in meaningful contexts without requiring the child to respond (Cleave & Fey, 1997). Two varieties of this stimulation are self-talk and parallel talk. In self-talk, an SLP talks about what he or she is doing, whereas in parallel talk, discussion centers on the child’s actions. Obviously, activities must be chosen carefully to provide sufficient opportunities for the target to occur. Focused stimulation should be semantically and pragmatically appropriate (Fey et al., 1993). The target feature is presented frequently while little pressure is placed on the child. The following is an example of focused stimulation within a conversational context: Child: Mommy made hamburgers. Mommy made ’tator salad. SLP: She must be a good cook. What else did she make? Child: A cake. SLP: She did? Yummy. Did she cook any hotdogs? Child: Uh-huh. SLP: She made a very nice picnic for the family. Did she get to play any games or did she just work? The language feature being targeted—the pronoun she—appears in the initial part of the sentence or in elliptical utterances in which shared information is omitted. Such frequent modeling plus recasts of

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the child’s utterances have been effective in facilitating use of certain language structures (Camarata, Nelson, & Camarata, 1994; Camarata, Nelson, Welsh, Butkowski, Harmer, & Camarata, 1991; Watkins & Pemberton, 1987). Although a grammatical feature can be made more salient or conspicuous by emphasizing it, this can change the basic meaning of a sentence. Say the following sentences out loud, emphasizing the boldfaced word: I’ll see you next week. I will see you next week While the first is probable, the second is definite. Or the following: I do my homework every day. I do my homework every day. We have a statement of fact followed by an argumentative accusation or defensive response. Instead, targets can be placed at the end of a sentence to aid working memory and enhance learning (Fey et al., 2003). This can occur in syntax (The girl is running to school. She really is.), morphology (He rides to work. He doesn’t walk; he rides.), or semantics (Don’t put the block on the box. Put it in.) Here’s an example of how it might work (Fey et al., 2003): Child: I do it. Adult: What about me? Child: You too. Adult: Great. You won’t do it. We will. Child: We will. Adult: Yes. We will do it together. Once a target has been modeled thoroughly, the SLP asks the child to respond in a manner similar to the model. Children who are young, low-functioning, or delayed may need imitation training, with a complete model presented immediately before their response. Imitation is a procedure in which the child repeats the language behavior of a facilitator, with the expectation that the child will acquire some aspect of the facilitator’s language. Imitation by a child enables him or her to become accustomed to the language feature being taught and its phonological patterns. This is especially important if the feature is difficult to produce. Imitation can be used as a first step in programs to teach specific language targets (Connell, 1987a, 1987b) or as a correction procedure when the child fails to respond or responds incorrectly. The procedure has been used successfully with several types of LI. By monitoring a child’s progress, an SLP can provide varied cues, including partial models and/or delayed imitation. A child may respond also to questions for which an SLP has modeled the answers. Initially, the modeled answer may follow the question, but this format can be altered so that the answer precedes the question, is given partially, or precedes the question by increasingly longer periods of time. An SLP might also model the type of response desired, although not the exact one. Although the modeling procedure seems stilted in writing, it can be applied very flexibly and works well with groups of children. In small groups, children who have acquired a certain target can serve as models for those who have not. By varying turns, an SLP can ensure that sufficient models are

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provided for different children. In a reversal of roles, the SLP can serve as a model for a child, while the child cues the SLP. Modeling alone may be less effective than other, more structured methods (Cole & Dale, 1986; Connell, 1987a). Whereas modeling is effective in changing the behavior of children developing typically, it is less effective than imitation with children with LI (Connell, 1987a). More structured approaches include imitation and elicitation in the form of fill-ins.

DI R ECT LI NG U ISTIC CU ES Linguistic cues for certain targets can be direct or indirect. Direct elicitation techniques might include the following target questions: To elicit . . . Verbs Noun subjects Noun objects Adverbs or adverbial phrases Adjectives or adjectival phrases

Specific words

Use . . . “What is he doing (are you doing)?” Use any tense. A benefit is that the question contains the target tense. “Who/what is verbing?” Again, the tense can be altered for the situation. “What is he/she verbing?” Tense can be altered for the situation. Obviously, verbs that do not take objects should not be used. “When/where/how is he/she verbing?” Tense can be altered. “How” questions can be used also to elicit process answers, as in “How did you make the airplane?” “Which one . . . ?” Tense can be altered. There should be an obvious contrast between choices for the response, such as big and little. These differences might be noted prior to questioning. Responses of a particular type can be modeled, as in “Which one ate the cookie, the littlest bear, the middle-size bear, or the biggest bear?” To keep the child from responding, “That one,” the SLP may want to cover the child’s eyes or use some barrier. Completion sentences, as in “She is playing in the _____.” Rising intonation after the last spoken word will signal the child to respond. If the SLP plays dumb or acts forgetful, the child’s behavior makes more sense conversationally.

Substitution requests also can be used. For example, pronouns can be substituted for old information. The facilitator might make a statement, such as giving one descriptor (“The dog is little”), and then ask the child to make a comment (“What can you tell me about the dog?”). This procedure also can take the form of a guessing game, as in “Is the dog little? Well, if the dog isn’t little, what can we say?” Of course, our goal is “He is . . .” Although these linguistic cues are conversational in nature, they will seem very nonconversational if used in nonlinguistic contexts in which they make no sense pragmatically. Questions should be used when the facilitator really desires the answer and when the child is interested in the topic of discussion. An SLP can model a response prior to asking the child a question, as mentioned previously. For example, “I think I want the yellow one. What about you?” This type of cue is more likely to elicit a longer utterance and is more conversational in tone. The goal is a sentence of similar construction. If you ask, “which do you want?” you may get “Red” in reply.

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One variation of the direct linguistic cue is a mand model (Hart, 1985; Rogers-Warren & Warren, 1985; Warren & Kaiser, 1986a, 1986b). This technique has been used effectively with preschoolers and with children with SLI (Olswang & Bain, 1991). This procedure follows a routine that is established prior to beginning any activity. The routine serves as a chain in which one stimulus cues the next. The mand-model approach usually is used for teaching new language features. In this approach, access to desired items is through an adult, who determines the criterion for acceptability. In this way, the adult, not the object, becomes the stimulus for talking. According to this procedure, “it is likely to be not so much what the teachers do—the forms of language they model— as the interactional context in which the adults’ models occur that facilitates children’s progress in language learning” (Hart, 1985, p. 81). In the four-step mand-model training sequence, an adult first attracts a child’s attention by providing a variety of attractive materials. This inducement may not be necessary if the child already displays an interest. Thus, the adult establishes joint attention with the child. In the second step, after the child has expressed interest, the adult (de)mands, “Tell me about this,” or, “Tell me what you want,” requesting a behavior trained previously. If there is no response, the adult moves to step three and prompts a response or provides a model to be imitated. In step four, the adult praises the child for an appropriate response and gives the child the desired item. Preschool peers can be trained to use the mand-model technique effectively (Venn, Wolery, Fleming, DeCesare, Morris, & Cuffs, 1993). Production has generalized to unprompted productions. I N DI R ECT LI NG U ISTIC CU ES Indirect linguistic cues are more conversational and situational in nature. For example, when attempting to elicit questions, the SLP might use unfamiliar objects hidden in boxes to set the nonlinguistic context. Beginning with “Boy, is this neat,” the SLP peeks into the box. An exchange might continue as follows: Child: What’s in there? Facilitator: This. (Takes the object out. Waits.) Child: What is it? Facilitator: A flibbity-jibbit. It does everything. Child: What it do? It is easy to see the interplay of nonlinguistic and linguistic cuing. Another indirect linguistic technique requires the SLP or language facilitator to make purposefully wrong statements. A child’s clothing can serve as the focus of this conversation, a technique I have dubbed “the emperor’s new clothes.” Facilitator: (Touching child’s red sweater) What a nice blue blouse. Child: This no blue blouse. In both examples, the child has given a final response that may be something less than what is desired. The SLP now can respond and begin to shape the child’s previous utterance into an acceptable form. These examples are only a very few of many indirect techniques. Others examples are listed in Appendix D. The possibilities are only limited by your imagination.

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CONTI NG E NCI ES Conversational consequences can be divided roughly into those that do not require a child’s response and those that do. Each type provides some feedback to the child, and each differs with the functioning level and degree of learning exhibited by the child. Contingencies Requiring No Response Contingencies that require no response from a child are nonevaluative or accepting in nature and can be used to increase correct production or highlight incorrect production for self-correction. When a child initiates or responds to some cue, the facilitator focuses full attention on the child, creating joint focus on the child’s topic. Because the child has established the topic, it now acts as a reinforcer for the child and can be used to modify the child’s language. Techniques used to modify the child’s response include fulfilling the intention, use of a continuant, imitation, expansion, extension and expiation, breakdowns and buildups, and recast sentences. By fulfilling the intention of a child’s utterance, such as handing the child a requested item, the facilitator signals the child that the message was acceptable as received. No verbal response is required. A continuant is a signal that a message has been received and acknowledged. These signals usually consist of head nods or verbalizations, such as “uh-huh” and “okay.” Continuants fill a speaker’s turn by agreeing with the previous utterance. In imitation, the facilitator repeats a child’s utterance in whole or in part but makes no evaluative remarks. Rising intonation, signifying a question, is not present. Again, this behavior acknowledges the child’s previous utterance. Imitation is especially helpful to the child when correctly produced features of interest are emphasized (“She is riding the bike”). Imitations might be preceded also by phrases such as That’s right (“That’s right, she is riding the bike”). In contrast to imitation, expansion or recast/expansion is a more mature, or more correct, version of the child’s utterance that maintains the child’s word order, for example: Child: It got stolen by the crook. Facilitator: Uh-huh, it was stolen by the crook. The use of expansion as a teaching tool is very limited for children functioning above about 30 months of age. In a variation of expansion, the SLP can prompt the child to imitate the expansion, although such requests disrupt the flow of conversation. A more appropriate variety of expansion for older children is a reformulation in which two or more child utterances are combined into one utterance that includes the concepts of each, as in the following: Child: The dog bit the man. The man ran away. Facilitator: Oh, the dog bit the man, who then ran away. At low levels of child grammatical production, the use of expansion and cloze, or fill-in-the-blank, procedures by adults produces more responses, more interpretations, and more syntactically complex utterances by children than does a question-and-answer procedure (Bradshaw, Hoffman, & Norris, 1998).

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For older children, extension is a more appropriate response. Extension is a reply to the content of the child’s utterance that provides additional information on the topic, as in the following: Child: It got stolen by the crook. Facilitator: Oh, I wonder if the crook stole anything else. Much of our behavior in conversations consists of replies to the content of the other speaker, and these comments can be used effectively regardless of the age or functioning level of the child. Extensions signal the child that the facilitator is attentive and interested. Breakdowns and buildups consist of dividing the child’s utterances into shorter units and then combining them and expanding on the child’s original utterance. The purpose is to help the child understand intrasentential relationships. I use this strategy as my great-great-uncle used to do to aid the processing of information, mulling it over before commenting. Child: It got stolen by the crook. Facilitator: (Emotional, disbelieving) It was. (Hmmm) It was stolen. Stolen by the crook. (Disgusted) By the crook. (Finally) It was stolen by the crook. This strategy works well, especially if the SLP or facilitator plays dumb or uses a silly puppet who just does not seem to get things right. The child may shake his head or say,“Uh-huh,” in agreement between the facilitator’s utterances. Finally, recast sentences maintain the child’s meaning or the relations while modifying the structure, and they immediately follow the child’s utterance. Recasts repeat at least one of the major lexical elements while modifying other parts of the utterance. For example, Child: He not eat. Adult: The dog is not eating his food. Is he hungry? Child: Not hungry. Adult: The dog is not eating his food. He is not hungry. Is the cat eating? Child: Uh-huh. Adult: The cat is eating his food. The dog is not eating his food. We may be splitting hairs in this example because these types of recast are very close to expansions. Sentences can also be recast in another form: Child: It got stolen by the crook. Facilitator: Was it stolen by the crook? OR It was stolen by the crook? OR The crook stole it. OR Did the crook steal it?

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These sentences can be recast in whatever form the SLP has targeted, although comments are easier for children than question forms. Note that even though the form is changed the relations are not: crooksteal-it. Although children with SLI can benefit from the use of them, recasts must be produced in much greater quantity than found in typical conversation to be of value (Proctor-Williams, Fey, & Frome Loeb, 2001). If the child says little, the SLP can recast his or her own utterances. If the child will not stop talking, the SLP can interrupt with “yeah” or “uh-huh” and insert a recast sentence. The effectiveness of recasts is based on four assumptions (Fey et al., 2003): easy for the child to attend, because the recast sentence is based on the child’s utterance. • ItIt isis easy the child to comprehend, because the recast sentence is similar to the child’s sentence. • It is easy for for the child to notice the change, because the recast sentence differs from the child’s sen• tence primarily in the use of the targeted feature. It is easy for the • in context. child to understand underlying relationships, because the recast sentence occurs Conversational Contingencies Requiring a Response Conversational contingencies that require a response are used when a child is able to produce the target reliably but has failed to do so in conversation or has produced the target inaccurately in conversation. A skilled use of both nonlinguistic and linguistic contextual cues should set the stage for production of the target in a situation in which it makes good pragmatic sense. As a fully participating conversational partner, the child has an interest in the conversation and in his or her own utterance. Thus, the child is motivated to modify production in order to maintain the conversation and receive the adult’s attention. Most of these contingencies note the child’s error or require the child to find the error, and request that the child produce the target more correctly. A second contingency type requests repetition or a correct or expanded utterance to strengthen correct production. A hierarchy of both types, ranging from contingencies that provide maximum input to the child to those that provide the minimal, would be correction model/request, incomplete correction model/request, reduced error repetition/request, error repetition/request, self-correction request, contingent query, repetition request, expansion request, and turnabouts. In a correction model/request, the facilitator repeats the child’s entire utterance, adding or correcting the target that was omitted or produced incorrectly, for example: Child: I builded a big tower out of blocks. Facilitator: I built a big tower out of blocks. Now you say it. (or “Tell me that again.”) The child is requested gently to repeat the facilitator’s model. Note that the error has been corrected for the child. Initially, the target may be emphasized to aid the child in locating the corrected unit. Later training might restate the child’s utterance as a question, as in, “You built a big tower out of blocks?” Obviously, there are some language features such as omitting am, that cannot be modeled in a question, such as you are . . .

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Because the entire utterance is desired in the child’s response, the facilitator should act confused to maintain the conversational nature of the interaction. Facilitator: You built a tower out of big blocks? No, you built a big tower out of blocks? Oh, I’m confused, tell me again. In a correction model/request, the child is provided with a complete or only slightly altered model of the correct utterance. The facilitator should require the child to produce correctly only those units that are currently targeted for intervention. It is difficult for some facilitators to reinforce utterances even when they contain errors, as in the following example: Child: I builted the most biggest tower out of blocks. Facilitator: You built the biggest tower out of blocks? Child: Yeah, I built the most biggest tower out of blocks. Facilitator: Uh-huh, how big was it? OR Yeah? What kind of blocks did you use? OR Oh! Where is the tower now? Note that the facilitator ignored “most biggest.” A conversational approach requires the language facilitator to remain focused on the target and on the hierarchy of teaching strategies being used. In contrast to a correction model/request, an incomplete correction model/request provides only the corrected target. The child must provide the rest of the utterance, as follows: Child: I builded a big tower with blocks. Facilitator: Built. Child: I built a big tower with blocks. Initially, the child will need a cue to repeat the utterance with the corrected target. As the child begins to exhibit some success at self-correcting, the facilitator can offer choice-making: “Is it builded or built?” The facilitator must be careful to use this form occasionally when the child’s initial utterance is correct as well as when it is incorrect. Otherwise, the child will recognize that the question is only used when he makes an error. In addition, the location of the correct answer should vary so that the child does not develop a strategy of always picking the first or second of the pair choice. Once the child has learned the target reliably within more structured situations, the language facilitator can use other techniques that require the child to supply the missing or correct target. With reduced error repetition/request, the facilitator repeats only the incorrect structure with rising intonation, thus forming a question. This contingency informs the child that the language unit in question is incorrect and must be corrected, for example: Child: I builded a big tower with blocks. Facilitator: Builded? Child: Built.

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The facilitator’s question is more conversational than the cue found in correction model/requests and is less disruptive to the flow of conversation. If the child fails to recognize the error, the facilitator can provide a corrected model by using an incomplete correction model/request. With error repetition/request, the facilitator repeats the entire utterance with rising intonation. The child must locate the error or omission and correct it, as in the following: Child: I builded a big tower with blocks. Facilitator: I builded a big tower with blocks? The emphasis on the error can be increased or decreased as needed. For example, increased emphasis might be used to aid the child in finding the error. If this technique is unsuccessful, the facilitator might provide a reduced error repetition/request. Once the child’s target knowledge is reasonably stable, the facilitator can use the error repetition/request even when the child is correct. This procedure helps children scan their productions spontaneously and to self-correct. A self-correction request does not provide the child with a repetition of the previous utterance. Instead, the facilitator asks the child to consider the correctness of that utterance from memory, for example, “Is/was that right/correct?” and “Did you say that correctly?” If the child is unsure, the facilitator can provide an error repetition/request. In contrast to the somewhat stilted tone of the self-correction request, the contingent query is very conversational. It is concerned more with comprehension of the message being sent than with specific targets. Nonetheless, this technique can be used effectively to signal the child that something may be amiss with the production. The child is left to scan recent memory to determine where communication breakdown occurred. Use of contingent queries should be limited because they can disrupt communication and frustrate the speaker who is continually asked to repeat. Young school-age children dislike having to repeat more than once or twice. Contingent queries may be specific or general, depending on the abilities of the child. In response to the sentence “I builded a big tower with blocks,” the facilitator might respond, “What did you do with blocks?” “What did you do?” or simply, “What?” If the child falsely assumes that his or her production was correct and merely repeats the error or omission, the facilitator might use a selfcorrection request. Correct productions of the target can be strengthened by asking the child to repeat. With a repetition request, the facilitator simply says, “Tell me that again,” or, “Could you say that again?” This technique also can be used conversationally, implying that the listener missed some portion of the transmission, not that the transmission was in error. If the child produces the target correctly but in a smaller unit than desired, such as a one-word response following a reduced error repetition/request, the facilitator can use an expansion request. The typical cue “Tell me the whole thing” is not conversational in tone. It is better for the facilitator to fake confusion and ask for a total restatement, as in the following example: Facilitator: Built? What was built? Who built it? I get so confused. You better tell me again. The advantages of using this routine to elicit language from children were discussed previously.

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Turnabouts may be more effective than repetition requests and are more conversational in nature. In a turnabout, the facilitator acknowledges the child’s utterance or comments and then asks for more, as in “Uh-huh, and then what did you do?” or “Wow, what will you do next?” or “That sounds like fun; what happened then?” The turnabout technique has been taught successfully to high school peers and parents and has been used effectively in conversation with children with LI (Hunt, Alwell, & Goetz, 1988, 1991). This partner-as-facilitator strategy reportedly can improve conversation skills significantly. The wh- questions used in turnabouts should be of a topic-continuing nature and thus support the child’s efforts to maintain the topic (P. Yoder, Davies, et al., 1994). This style of responding is especially helpful to preschool children and children with LI. Several relational terms also may be used in open-ended utterances to aid the child in providing more information of a specific nature. For example, the facilitator might repeat the child’s utterance with the addition of but to elicit contrary or adversative information, or and to elicit complementary information. Child: We played games at the party. Facilitator: What fun. You played games at the party and . . . Child: And we had cake and ice cream. Other types of relationships and terms are as follows (J. Norris & Hoffman, 1990b, pp. 78–79): Temporal Causal Adversative Conditional Spatial

and then, first, next, before, after, when, while because, so, so that, in order to but, except, however, except that if, unless, or, in case in, on, next to, between, etc.

The conversational contingencies just discussed can be arranged in a hierarchy similar to that in Table 10.2. This arrangement will differ with the language unit being targeted. The facilitator who is familiar with this hierarchy can respond to the child’s utterances in a top-down manner that enhances language stimulation and facilitates language learning.

Top-Down Teaching The methods presented so far are helpful no matter what method of intervention used by an SLP. It is in the arrangement of these techniques that everything changes. A functional approach is one that uses conversation whenever possible as the milieu for instruction. Employing a top-down intervention model, an SLP helps a child repair conversational errors as they occur within context. Initially, the SLP selects targets based on the child’s needs and activities and topics of conversation based on the child’s interests and experience. Placing intervention within everyday routines or play is ideal. By manipulating both the nonlinguistic and linguistic context, the SLP can elicit the targeted language feature and then provide just enough input to aid the child’s production. The amount of input needed by the child depends on the child’s ability and will differ across children.

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TABLE 10.2

Hierarchy of Conversational Contingencies

For the examples, the child’s utterance is “I sawed two puppies.” The facilitator should use the contingency farthest down on the list that ensures the child’s success with minimal input. Facilitator Input

Conversational Contingency

Example

Maximum

Correction model/Request

I saw two puppies. Can you tell me again? (The cue to say it again is optional, unless the child does not repeat spontaneously.)

Incomplete correction model/ Request

Saw. Can you tell me again? (Again the cue is optional.)

Choice-making

Is it saw or sawed?

Minimum

Reduced error repetition/Request

Sawed?

Error repetition/Request

I sawed two puppies?

Self-correction/Request

Was that right?

Contingent query

I didn’t understand you. Say it again, please. (Other options include Huh? and What? or, in this example, What did you do?)

Expansion request

Tell me the whole thing again.

*Repetition request

Tell me again.

*Turnabout

You did? I love puppies. What did they look like?

*Used with complete, correct responses.

Let’s assume that a child is working on irregular past tense and the SLP is inquiring about the past weekend, specifically what the child saw, ate, drank, and so on. In this case, the child can self-repair but requires that the error be highlighted in order to do so. Note in the following example how the child needs more assistance than first assumed by the SLP. It is also important to note that the SLP does not correct the error for the child. Supplying the correct response builds dependence on this type of help and does not foster independence. Example of hierarchy in use: Child: I sawed two puppies. Partner: Was that right? (Self-correction request) Child: Uh-huh. Partner: I sawed two puppies? (Error repetition/request) Child: Yeah. Partner: Sawed? (Reduced error repetition request) Child: Saw. I saw two puppies. Partner: Uh-huh, tell me again. (Repetition request) Child: I saw two puppies. Partner: I think I love puppies more than kittens. Where did you see them? (Turnabout)

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When the child gives the correct response, the SLP does not respond with that tired old “Good talking!” Instead, he or she strengthens the correct response by asking for a repetition, then replies conversationally and uses a turnabout to elicit the next response. Let’s eavesdrop some more. Child: At the pet store. Partner: I’m confused. What happened? Child: I saw the puppies at the pet store? Partner: Oh, you saw them at the pet store. Pet stores are fun. When did you go? Child: I goed on Saturday. Partner: Was that right? Child: I went on Saturday. Partner: Oh, you went to the pet store on Saturday and saw the two puppies. Did you go alone? Notice how each response by the SLP tries to elicit another that includes use of the target, the irregular past tense. The functional approach to intervention can be challenging for an SLP at first. Once she or he begins to think in a new way, and with practice, functional teaching becomes second nature—just simply the way the SLP talks with children. The intervention approach can be used in almost any interaction with a child, thus giving an SLP ultimate flexibility.

Conclusion Both the nonlinguistic and linguistic contexts can be manipulated by an SLP and other language facilitators to teach language to a child and to encourage use of structures recently acquired. By using the various techniques described in this chapter, facilitators can maximize interactions with child with LI. Although it would be ideal if facilitators used the full range of techniques, even the adaptation of some would help make learning more conversational in nature.

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A

number of training techniques effectively teach the use of linguistic features to children with LI. The success of intervention varies with the particular linguistic feature trained, the manner and duration of the training, and the characteristics of the individual child (Leonard, 1981). Prior to beginning intervention, an SLP should examine all deficit areas for a given child and apply a “What’s the point?” criterion (Lilius, personal communication, 1993). In short, an SLP is concerned with the importance of individual deficits on a child’s overall communication. Each deficit should be evaluated to the extent that it contributes to a child’s communicative functioning. Deficits that greatly affect functioning should be targeted first for intervention. Those that do not affect overall communication fail the “What’s the point?” test. It is important that an SLP consider generalization at the beginning of intervention and make crucial training decisions on the basis of generalization to the everyday environment. At least a portion of each lesson should involve the conversational context. Intervention that focuses solely on linguistic form can result in limited progress and lack of generalization (Goetz & Sailor, 1988; Halle, 1988). Preferable are specific situations in which language form skills are necessary, such as using the telephone or play (Mire & Chisholm, 1990). In general, in this chapter we discuss a developmental hierarchy for intervention, modified where appropriate by sound teaching principles research and evidence-based practice. It is important to remember that development is a gradual process with much overlap between language features. Development is also not “domain-specific” (Kamhi & Nelson, 1988). Rather, changes in one area of language can affect other areas. When possible, apply the functional approach explained throughout this text. Use it as your overall model. At all levels of instruction, some elements of the functional intervention model can be used. Intervention should be fun and challenging, using real conversational exchanges between the child and partners wherever possible. Thus, both partners are involved actively in the process. In this chapter we explore some proven and some promising techniques for language intervention. I have attempted to include the best evidence-based practices. For clarity, I have divided the chapter into four aspects of language: pragmatics, semantics, syntax, and morphology. We discuss hierarchies for training and techniques that lend themselves well to each area. The final portions of the chapter deal with the special needs of children from CLD backgrounds and the clinical application of computers. The best intervention addresses language holistically so that a child can experience newly acquired language as it is used in communication. Some SLPs accomplish this goal by targeting skills in more than one area of language or by using a stage approach in which a few training targets from a stage of development are targeted simultaneously. Suggested activities are presented in Appendix E.

Pragmatics Traditional language intervention goals are usually product rather than process oriented (Wilkinson & Milosky, 1987). In other words, language forms are targeted, whereas language use is tangential. Although a theoretical shift has occurred toward pragmatic models of language, many intervention programs continue to emphasize syntax and semantics. In general, communicative context is used only to create fun or as an afterthought relative to generalization. Children can acquire very complex forms without totally comprehending them. It is essential, however, that they understand the functional qualities or uses of the forms being taught (Snow & Goldfield, 1983). We might do better to teach the appropriate contexts in which to use linguistic forms.

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When appropriate, linguistic forms can and should be targeted within a functional context. For example, an SLP might teach requesting as a function of the goal of gaining information, action, or materials. The SLP can help children identify the linguistic form that goes with each goal. Subsequently, he or she may teach alternative forms for such requests. Through role-playing and the use of videotaped interactions, an SLP can teach a child to identify situations in which the desired information, action, or material was requested inadequately, inaccurately, or inappropriately. The SLP also can train either repairs and reattempts or requests for clarification. Likewise, he or she can help the child to identify the requested goal of another speaker and to respond appropriately. An SLP may directly target a number of pragmatic skills within a single lesson and should use many everyday events and play activities to teach pragmatic skills. For example, telephone conversations teach acknowledgment of the interaction, conversational opening and closing, topic maintenance, and referential communication. The use of situationals and different voices on the other end of the phone can help a child adapt to differing situations scenarios. For example, by pretending that he or she is lost, an SLP can teach requesting and giving assistance and information, roles, and following directions. Construction toys used to copy a model, such as Legos, clay, and Play-Doh, or construction paper can teach requesting assistance, referential communication, giving and following directions, and topic maintenance. More difficult tasks will require requesting assistance. Several children’s stories can be enacted to help a child learn roles. The use of puppets or dolls or different costumes also will aid the learning of role taking. Finally, an SLP can use any number of activities for referential communication. Children can describe objects seen in books, on computers, or through toy periscopes, felt in paper bags, or hidden. Such activities as I Spy and Twenty Questions also aid referential communication growth and foster requesting and giving information. Effective intervention must enhance language and social skills while generalizing to authentic interactions (Timler, Vogler-Elias, & McGill, 2007). Although more structured clinician-centered intervention methods may be required for some children, generalization to a child’s everyday environment is key to success. I NTE NTIONS Children select and acquire utterances that are communicatively most useful. In training, an SLP is concerned with the breadth of intentions that a child is able to express. The following section addresses the training of several intentions. In Chapter 12, some methods to be used in the classroom are discussed. Appendix D also provides several indirect linguistic cues useful for eliciting different functions. Calling for Attention Calling for someone’s attention requires the presence of a person whose attention the child seeks or who is essential to completion of a task. In general, children seek attention from adults who provide it. Within intervention, facilitators might give a child an object and ask him or her to take it to an adult who, for the purpose of training, initially ignores the child. The child also might be asked to relay a message to someone else. Facilitators should attend to a child as soon as the child requests attention. If the child continually demands attention or uses inappropriate behavior to get attention, the facilitator will have to set

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some limits, such as only responding in certain situations and never responding to inappropriate behavior. The form of attention-requesting is usually a child calling a facilitator by name or gaining attention by some other means, such as tapping the listener’s shoulder, moving into the visual field of the listener, leaning in the direction of the listener, or using eye contact. The child also may specify how the facilitator should respond by making a request. These sequences are easy to train within a variety of activities. Requests for Action Requests for action can be trained at mealtime, within small group projects, or during almost any physically challenging task. A facilitator will need to design situations in which children require assistance to complete a task. To encourage requesting, a facilitator can use games in which children must solve problems. Tasks also may be sabotaged by a facilitator (see Table 10.1). In requests for actions, attention is gained first, and the form of the utterance is interrogative or imperative. Requests for Information Children with LI often do not see other persons as sources of information and may produce few such requests of this type. Although the environment can be manipulated to encourage requests for objects and actions, it is not as easy to encourage or increase a child’s need and desire to seek information. Requests for information require that a facilitator omit essential information for some novel or unfamiliar task, such as an art project, a new game, or some challenging academic task. Objects unknown to a child may be introduced without being named or their purpose explained. A child can be prodded gently to ask questions if asking does not occur spontaneously. A child must recognize both the need for this information and that another person possesses the knowledge. Recognition of need is often the most difficult aspect of this training. Confrontational naming tasks, with objects known and unknown to a child, may encourage initial requesting for information. The form of requests for information is either a wh- or yes/no interrogative with rising intonation, as in “what’s that?” or “Is that a marker?” A facilitator also might encourage the child to ask questions by questioning him or her about other people’s feelings or actions of which the child has little knowledge. The child then can be cued with “Why don’t you ask (name)?” This tactic can be used with naming tasks as well, as in “See if Juan knows what this is.” A child should be expected to ask questions that reflect the forms he or she is capable of producing. The facilitator’s verbal responses discussed in Chapter 10 can be used to help the child modify incorrect, inappropriate, or immature responses or learn new ones. Requests for Objects A facilitator can easily train requests for objects within art tasks, group projects, snacktime, job training, or daily living skills training, such as dressing and hygiene. It is essential that a child actually desire the object he or she is to request and that the facilitator can provide it. A facilitator can change the environment to increase both the opportunities for requesting and the behaviors that direct a child’s attention to these opportunities. Many situations, especially those with groups of children, provide an opportunity for overlooking a child’s turn, thus encouraging requesting. Of particular importance is a coordinated program designed to teach requesting for use in the

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TABLE 11.1

Guidelines for Caregiver Elicitation of Requests for Objects

Make statements throughout the day about objects that the child might prefer. Wait for a response. Use elicitation behaviors to accompany high-interest activities and play. These behaviors include the following: Modeling with an imitative prompt. Facilitator provides a model of a request and asks the child to imitate.

Direct questioning. Facilitator asks, “What do you want?” or “What do you need?” Indirect modeling. Facilitator provides a partial model followed by an indirect elicitation request, such as, “If you want more X, let me know (or, “ask me for it”) or, “Would you like to X or Y?” Obstacle presentation. Facilitator requests that the child accomplish some task but provides an obstacle to accomplishment. “Please get me the chalk over there.” (There is no chalk.) “Pour everyone some juice.” (The container is empty.)

General statement. Facilitator makes a verbal comment about some activity or object that the child might want to request. The facilitator entices the child. “We could play Candyland if you want to.” “I have some Play-Doh on that high shelf.” Set up specific situations to elicit requesting. Provide direct and indirect models as often as possible without requiring the child to imitate. Provide a model at appropriate times when the child appears to need assistance or is looking quizzical. Have the child attempt difficult tasks in which help is occasionally needed. Respond immediately and naturally to any verbal request. Source: Adapted from Olswang, Kriegsmann, & Mastergeorge (1982).

everyday environment by approximating that environment and by training those within that to model and elicit requests. Table 11.1 includes general guidelines for caregiver elicitation techniques. Expression of this intention usually begins with eye contact or some attention-getting behavior, such as calling environment a name. The form, usually accompanied by a reaching gesture, is interrogative (“can I have . . . ?”) or imperative (“give me . . . ”) and specifies the desired object. An SLP can elicit denials by giving the child something other than what he or she requested or by giving the child something undesirable. The child can reject either an action or proposal. The speaker uses emphatic stress, and the utterance is in a negative form. Responding to Requests Responses may take the form of an answer to a question or a reply to a remark. These forms are very different and require different skills. In responding to questions, children must recognize that they possess the answer and that they are required to reply. Questions require answers from the other partner. Initial training should disre-

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gard the correctness of the answer in favor of reinforcing answering in general. At this stage, teaching wh- question responses should reflect the appropriateness-before-accuracy pattern (Parnell et al., 1986). Responding with an incorrect answer is preferred over no answer at all. In a situation in which a facilitator asks about objects known to a child, it is fairly certain that the child will give the appropriate answer, although it might be inaccurate. The information requested can expand gradually to conform to the child’s ability to respond. Appropriate responses not only include answers in reply to questions but involve the correct emotional level of responding. Some children with LI have difficulty identifying the emotions of others and of themselves and placing these in a form of expression. We can teach awareness and expression through a three-step intervention model (Way, Yelsma, et al., 2007): 1. Connecting physical experience and emotions 2. Increasing awareness of own emotional state 3. Connecting emotion to expression Activities within each step are presented in Table 11.2. Replying to a request is more difficult to teach than answering because a response is expected but not required. A child’s response may be in the form of nonlinguistic compliance or a linguistic response. Children’s comprehension of different requests will vary with age (Ervin-Tripp, 1977). Table 5.5 contains the ages at which different types of requests are understood. A child can be helped to recognize the need to reply by physical signs from the SLP, such as a head nod, or the passing of an object to signal “It’s your turn.” A child’s ability to reply may be hindered by an inability to determine the topic or to formulate a response. A facilitator may enhance linguistic processing by having the child repeat the request. Over time, the facilitator can modify this procedure to whispered imitation, mouthing, and silent repetition until the process is internalized by the child. In this way, children can be helped to identify important information in requests and in formulating responses. Statements Show-and-tell, discussions, and current-event activities help children state information. During discussions of high-interest topics, such as, holidays, pets, and family events for children or dating, friends, and competitive games for adolescents, a facilitator can encourage offering of opinions. A facilitator also can use mock radio and television broadcasts. With a little cutting and some paint, he or she can convert a large appliance box into a console television from within which children can deliver daily newscasts of information. A facilitator may either know the information a child is sharing or not. In the first instance, the child is recalling a shared event; in the latter, the child is presenting new information and can assume that the facilitator has very limited information. Each situation has different informational needs and requires some presuppositional skill to determine the necessary amount of information to convey. Children can be taught how much information to include (see under Presupposition heading). The form is declarative. Initially, the child must secure the listener’s attention and state the discussion topic. Statements can be expanded into narratives whose purpose is also to convey information.

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TABLE 11.2

Teaching Emotional Awareness and Expression

Connecting Physical Experience and Emotions

• •

Bodywork, such as recognizing one’s heartbeat, sweating, flushing, or a stomachache, can help a child turn his or her attention internally. Connecting physical states to specific feelings and learning methods to calm oneself when feeling anxious or upset.

Increasing Awareness of Own Emotional State

• • • • •

Drawing the child’s attention to the important features of expression, then modeling language to express those feelings. SLPs might observe and comment on facial expressions, body expressions, vocal affect, and labels or words in affective experiences. Role-playing various feelings. Identifying feelings of characters in stories, videos, or photos; or using art therapy. Using feelings strips on which is the unfinished sentence, “I feel . . . ” into which children can insert feelings faces to describe their feelings. In this way, children are taught physical cues for different feelings at the same time as they learn to become aware of their own. Identify single feelings and then learn to recognize multiple feelings at a particular moment. Begin with primary emotions such as joy, sadness, anger, fear, disgust, and interest, and then progress to more sophisticated complex emotions that require self-reflection, such as empathy, sympathy, guilt, envy, shame, regret, and pride.

Connecting Emotion to Expression

• • •

Drawing pictures to express feelings nonverbally in preparation for addressing them verbally. Expressing emotion through role playing, pretend play, and acting out dramas. Creating a skit from an index card listing multiple feelings, and then having other children guess the feelings being portrayed. • Acting out stories from books, TV shows, and movies. • Reading and listening to narratives and making sense of character perspectives in the context of story events. SLPs can use questions that probe linguistic and socioemotional awareness, questions that guide students to reflect on feelings and organize these ideas using language to describe, report, predict, and interpret feelings and motivations. • Oral and written storytelling to share personal narratives while developing integrated language skills and expressiveness. Source: Denham & Burton (1996), Greenberg & Kusché (1993), Hyter, Atchison, & Blashill (2006).

CONVE R SATIONAL AB I LITI ES More than other areas of language intervention, the training of conversational abilities requires the use of actual conversational situations. Ritualized communication that interferes with interpersonal communication, such as echolalia, can be modified gradually into acceptable and conventional routines, such as greetings, conversational initiations, and requests for repair (Lord, 1988; Lord & Magill, 1988;

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Magill, 1986). For children with Asperger’s syndrome, high-functioning autism, or other social interactional difficulties, the following conversational goals seem appropriate (Kline & Volkmar, 2000): of verbal and nonverbal communication, including initiating a conversation and • Conventions selecting appropriate topics. awareness and social problem solving, including perceiving verbal and nonverbal cues and • Social making inferences. and management, including ability to participate in diverse communication activ• Self-evaluation ities and to control one’s own behavior. Social routines can be memorized and practiced in different situations that help a child become more flexible in their use. Variations can be taught through different facilitators and situations. For example, one does not offer to shake hands when the potential partner has her or his arms full (Lord, 1988). If nothing else is accomplished in training, a child learns appropriate entry into conversations (Prizant & Wetherby, 1985). For adolescents with LI, the give-and-take of conversation and the important social interactions of peers are often extremely difficult. The result can be social isolation. This can be hastened by the peer group’s negative perceptions of a child with LI. In a study of TD adolescents, several behaviors that may or may not be present in teens with LI occur frequently (Turkstra, Ciccia, & Seaton, 2003). These include at a conversational partner, especially when listening. • Looking Nodding and showing neutral and positive facial expression. • Responding verbally to acknowledge understanding (Uh-huh, Yeah). • Giving contingent responses. • You may recall that contingent responses may be semantically contingent (on-topic) and/or pragmatically contingent (appropriate). These four behaviors suggest targets for helping children with LI interact more appropriately. While only limited research data exist, they suggest intervention methods that may work for some teens (Brinton, Robinson, & Fujiki, 2004). A two-step intervention program could (1) help youth with LI think of conversation as a reciprocal endeavor that requires adjustment for one’s partner and (2) provide interactive strategies to solicit and act on conversational contributions by others. Intervention can occur within structured, conversation-focused, small-group activities (Nippold, 2000). The atmosphere should be positive with plenty of opportunity for success. Within this context, the SLP models appropriate responses and this modeling is, followed by teen practice, then peer analysis and feedback with the use of video recordings and small-group discussion (Hess & Fairchild, 1988). Scripted sequences and role-play can be very helpful. Video clips and guided observation and comment can be used to aid an adolescent to comment on the nature of exchanges, feelings and thoughts of participants, and interpretation of reactions. The bulk of the time, however, should focus on interactive strategies, moving from highly structured situations in which turns and topics are controlled to more free-flowing conversations. Clients can be trained in variations of comment-question, in which they make a contingent comment on their partner’s utterance and then ask a related question. Listening and comprehension skills can also be

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enhanced. From here, additional interactional techniques, such as how to ask someone’s opinion or how to draw listeners into the conversation, can be taught. Entering a Conversation Although entering an interaction can be a formidable challenge to children with LI, kindergarten children can be taught play-entry strategies through modeling and prompting by an adult (Selber Beilinson & Olswang, 2003). Four nonverbal “low-risk” strategies can be taught initially through modeling and visual picture prompts: over to your friend. • Walk Watch • Get a toyyourlikefriend. the one your friend is using. • Do the same thing as your friend. • A fifth, “high risk” strategy includes verbal initiation. In modeling verbal initiation, the classroom teacher, aide, or SLP helps a child select a toy similar to that of another child and says to the second child, “We’re building with blocks just like you.” This can be an opening for the other child to respond by asking the child to join. A more direct model might include telling a child what to say. When a child can successfully imitate the opening behavior, the adult gradually reduces the model and tries to prompt it through toys and picture and verbal prompts. These are also reduced until a child can initiate spontaneously. Other strategies might include interpreting (I think Mohammed wants you to play with him), giving suggestions (Maybe Kwanzi would like to see what you made), referring to a peer (Maybe Alex can help you hold the paper while you glue it), and commenting on similarities (Jin is making a costume too. Tell him about yours.) (Weitzman & Greenberg, 2002). Presupposition A speaker’s semantic decisions are based on her or his knowledge of the referents (the thing to which words refer) and the situation and on presuppositions, or social knowledge of a listener’s needs. A speaker needs to provide information that is as unambiguous as possible. In other words, the speaker and the listener need to share the same linguistic context. Often, children with LI are unaware of their audience’s needs (Bliss, 1992). With maturity, children developing typically are increasingly able to perspective-take, the greatest growth occurring in middle childhood. In contrast, children with LI seem to improve little with age. Breakdown may occur in social-cognitive processes and/or linguistic production (Bliss, 1992). Significant improvement can occur, however, from training speakers to be aware of listener needs. The two aspects of training are (a) what information to relay and (b) how much. The first can be trained with descriptive or directive tasks in which a child is the speaker. A listener tries to guess or draw the described object or to follow the directions. The facilitator can use barrier games, in which he or she places an opaque barrier between the speaker and the listener, for teaching speakers to be aware of their listeners’ needs (Wallach, 1980). Some clinical materials are available commercially (McKinley & Schwartz, 1987). Because the speaker and the listener do not share the same nonlinguistic context, the bulk of the information must be carried by the linguistic element in an unambiguous manner if the listener is to comprehend. The list of fun activities in which a child directs an adult in how to do something is endless.

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When the child is the listener, the SLP can send ambiguous or incomplete messages or directions to give the child an opportunity to identify the missing semantic elements. Obstacle courses are a good vehicle through which the child can be directed or direct others. Training the correct amount of information to transmit may be more difficult. Of course, giving insufficient information in the tasks previously mentioned would make the directions difficult to follow. The SLP can train children to give more, as well as more accurate, information. For a child who gives too much information, these tasks may be trained initially one descriptor or one step at a time. These tasks then can be grouped into multidescriptor or command steps so that the child experiences offering more information. The relating of very discrete or limited events, such as combing your hair or washing your face, also can control the amount of information to be relayed. The SLP can help the child monitor his or her own production to know when redundancy occurs. The SLP can gently remind the child that certain information was relayed previously. In subsequent training, the SLP can quiz the child about the novelty or the lack of information presented. This will help the child identify the correct amount of information. Referential Skills Referential skills include identifying novel content and describing this content for a listener. Children with LLD have been trained successfully to use referential skills through the use of barrier games (Bunce, 1989). The description of physical attributes (“It’s big and white and furry.”) is somewhat easier to teach than are relational terms, such as location (“He’s in front of the computer.”). Guessing games can be lots of fun and very instructive. It may be best to pair a child with LLD with another child, rather than with an adult, because the child with LLD may assume that the adult partner intuitively knows the object or is pretending not to know. Thus, the child may provide less information to an adult partner. Topic Topic performance is an important intervention target for the following reasons (Bedrosian & Willis, 1987): 1. Its use is one means of coordinating conversations and actions, thereby fostering development of interpersonal relations. 2. It regulates the sequence of a conversation. 3. It involves the initiation of conversation. 4. It requires listening and comprehension to maintain the flow of conversation. 5. It provides a framework for making relevant contributions. In short, topic offers an encompassing framework for considering other language skills. Unlike greetings, which vary only slightly across situations, topics and methods of topic introduction and identification are context-dependent (Lord, 1988). Topic identification is a complex process that develops gradually through school age and adolescence. A successful strategy is usually to engage in whatever everyone else in the conversation is doing. Topic Initiation Initiation is the verbal introduction of a topic not currently being discussed. Children often do not understand the purpose of conversations or are reluctant to introduce topics for discus-

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sion. Topic initiation implies an active conversational strategy. A child with LI may not be adept at introducing topics clearly or may have very limited topics to discuss (Dollaghan & Miller, 1986). Children with ASD or TBI may introduce unusual or inappropriate topics (Rumsey et al., 1985). Adolescents with moderate-to-severe ID have been taught to initiate a topic through the use of facilitator waiting and through training in the purpose of conversation (Downing, 1987). In the first step of training, a facilitator maintains eye contact for 10 seconds but does not speak. Planned delay can be an effective strategy for prompting clients to initiate conversation. If the child does not initiate the conversation during this wait, the facilitator can explain the purpose of conversation and the enjoyment that can result (Downing, 1987). He or she also can describe the roles of speaker and listener. Then the facilitator returns to the waiting strategy. If the child still does not respond, the facilitator can suggest that the child find something of interest to discuss by looking through a magazine or pictures from the child’s life. The facilitator then returns to the waiting strategy. If the child fails to initiate again, the facilitator can model a topic initiation. Some children fail to initiate conversations and topics because of a history of failure. It is important that the facilitator focus fully on the child when he or she initiates and follow the child’s lead. The facilitator should try not to interrupt the child. The facilitator might first teach the child to gain a listener’s attention. When the child inadequately introduces a topic, the facilitator can request further information to identify the topic. Focused activities, such as describing pictures or a shared event or following directions, will show the child the need to share the referent with the listener. The facilitator initially can tolerate inappropriate topics to give the child some success. Gradually, the facilitator can discuss the inappropriateness of these topics and gently steer the conversation to more appropriate ground. He or she can suggest topics (“Maybe you’ll tell me about . . . ”) and leave it for the child to initiate. The facilitator also can train the child to ask other people about their likes and dislikes, favorite foods, sports, TV shows, or exciting trips or vacations in order to include otheroriented topics in the child’s repertoire. Traditional therapy often centers on the immediate context and may inhibit generalization by failing to incorporate nonimmediate contexts. In part, the discussion of the immediate context is related to the stimulus items used with children. To increase the frequency of memory-related topics, the facilitator can encourage the child to talk about feelings or activities engaged in prior to the conversation (Bedrosian & Willis, 1987). Elicitation can be direct (“What did you do yesterday?”) or indirect (“I wonder what you did yesterday”). The facilitator can encourage the child to ask the same information of the language facilitator. In addition, she can engage the child in activities and then ask the child to discuss what was done. The SLP can provide feedback in the form of expansions of the child’s utterances. Future-related topic initiations are similar, such as discussing what the child will do next. The use of such conversationally based strategies can increase nonimmediate topic initiations, as well as the general level of syntactic performance (Bedrosian & Willis, 1987). Topic Maintenance An SLP can continue the conversation by commenting on the topic a child initiated and by cuing the child to respond (Downing, 1987). The SLP can use turnabouts—usually a comment followed by a cue for the child to respond, such as a question—to keep the conversation flowing and on-topic. Questions should make pragmatic sense; that is, the facilitator should not know the answer prior to asking. Table 11.3 is a list of various turnabouts. Off-topic responding may indicate that a child is inattentive or cannot identify the referent or topic presented. Children who are inattentive may be distracted easily and need help determining how

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Variety of Turnabouts

Type

Example

Tag

Child: Baby’s panties. Mother: It’s the baby’s diaper, isn’t it?

Clarification (contingent query)

Huh? What?

Specific request

What’s that?

Confirmation

Horse? Is that a hippopotamus? (Hand object to partner and give quizzical glance)

Expansions Suggestions Corrections Behavior comment

I want one. No, it’s a zebra! (Expectant tone) You can’t sit on that.

Expansive question for sustaining conversation

What would the police officer do then?

Source: Adapted from Kaye & Charney (1981).

to focus their attention. Children with ASD may make off-topic comments because of an assumed lack of background information and experience or a lack of realization that such background is known (Lord & Magill, 1988; Rutter, 1985). A facilitator can help a child who cannot sort through the information to identify the referent or topic through the use of questions and prompts that highlight those semantic cues of importance to the child (T. Williams, 1989). Practice conversations with various partners and topics can provide an opportunity to learn and generalize. The facilitator can keep the child on-topic with such cues as “Anything else you can tell me about (topic)?” and, “Tell me more about (topic).” When a facilitator and a child have shared the same experience, the facilitator can act as a guide to keep the child on-topic. The facilitator also can help the child sequence events through the use of questions (“Then what happened?”) or probes (“Are you sure that happened next?”). The facilitator should avoid dead-end conversational bids. Dead-end bids result in a short response that ends the interaction. A common dead-end bid is the overused “What did you do today?” to which every child knows the answer: “Nothing.” Facilitators can be more specific in their topic bids. Duration of Topic A facilitator may help an incessant talker by using very limited topics with definite boundaries, such as “What animals did you see at the zoo?” If the child strays beyond the topic, the facilitator should interrupt. He or she then can remind the child of the topic and gently bring him or her back to it. The facilitator also should alert the child when he or she has provided enough information or is redundant. Such phrases as “You’ve already told me about X” or “I’ll only answer that question one more time” help the child establish boundaries. Children who provide too little information can be encouraged to provide more with “Tell me more.” An SLP also can play dumb with such utterances as “Well, I guess it was pretty boring if that’s

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all that happened.” In general, children remain on-topic longer when they are enacting scenarios, describing, or problem solving (Schober-Peterson & Johnson, 1989). Turn Taking It is important not to initiate turn-taking training while also attempting to train topic maintenance. Too many new training targets may confuse the child. A facilitator may have to tolerate off-topic comments initially to correct inappropriate turn taking. Turn taking can begin at a nonverbal, physical level. A facilitator and a child can pass items back and forth as they use them. The item then can become the symbol for talking you talk when you hold the object. Many structured games also require turn taking. The facilitator also can provide a turntaking model by imitating the child’s spontaneous speech or using verbal games and motion songs with groups of children. Later, the facilitator can use turnabouts or a question-answer technique to help a child take verbal turns. Nonlinguistic cues, such as eye contact and nodding, can signal the child to take a turn. The facilitator can decrease questioning gradually in favor of these nonlinguistic cues and wait for the child to take a turn. Children can be taught attention-getting devices, such as increased speaking volume, to gain a turn. Games in which the child directs other people are highly motivating. Turn taking is appropriate if it does not interrupt others. A child who is overly assertive and who continually interrupts may need to be reminded not to do so. The SLP might focus instruction on identifying when speakers have completed their turns. He or she also should explain appropriate interruptions, as in emergencies. Structured exchanges through use of an intercom or mock police radio may help children understand the importance of turn allocation through play. Structured games, such as Twenty Questions, also foster turn-allocation learning. In fact, there are many games that require turn-taking skills. Conversational Repair Through monitoring, each conversational partner detects and reacts to conversational breakdowns by other people when she or he is speaking and by oneself when a partner is speaking (Markman, 1981). Children with LI often seem unaware of the distinction between understanding and failure to understand and rarely act when they do not. An SLP may modify comprehension monitoring through the use of audiotaped language samples in the following training sequence (Dollaghan & Kaston, 1986): 1. 2. 3. 4.

Identification, labeling, and demonstration of active listening. Detection of and reaction to inadequate signals. Detection of and reaction to inadequate content. Identification of and reaction to comprehension breakdown.

Although this sequence can be trained easily in an audio-recorded mode with first graders, generalization to actual conversational use should not be neglected. The introduction of puppets, dolls, or roleplaying at each step can facilitate this generalization. Written scripts may be used with older children, targeting frequent conversational contexts. Comprehension monitoring can be facilitated when a child takes an active role in the process. The child is taught first to identify, label, and demonstrate active orientation to listening behaviors, such as sitting, looking at the speaker, and thinking about what the speaker says (Dollaghan & Kaston, 1986). After learning to distinguish successful and unsuccessful performance of the three active listening

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behaviors, the child labels and demonstrates each. The child also might repeat the previous speaker’s utterance or reply to such questions as “What did (name) just say?” This can be worked into many play situations, such as playing store or restaurant. Next, the child is taught to detect and react to signal inadequacies, such as insufficient loudness, excessive rate, or competing noise. These concrete obstructions that prevent representation of the message are relatively easy to identify and enable a child to learn the difference between understanding and not understanding (Dollaghan & Kaston, 1986). Within everyday activities, the facilitator can encourage clarification requests from the child by mumbling or talking too fast. This technique works especially well when giving directions needed to complete some fun task. The facilitator occasionally can ask the child, “What did I say? How can we find out?” Once able to identify signal inadequacies, a child can be taught a variety of responses for requesting clarification. Requests may include general appeals, such as “Pardon?” (or “What?”), “I can’t hear you,” and “Wait . . . Now say it again” (or “Again please”), or more specific requests, such as, “Talk louder please” (or “Louder”), “Could you talk more slowly?” (or “Slow down”), and “Did you say X?” It is best to begin with more general requests and then move to more specific ones. The request form should reflect the child’s overall syntactic level. Next, a child can be taught to detect and react to content inadequacies, such as inexplicit, ambiguous, and physically impossible commands. For example, because inadequate content may not always be obvious, the SLP can ask the child to repeat the message to himself or herself and/or to the speaker and to attempt the task demanded (Dollaghan & Kaston, 1986). Again, the child is taught various methods for requesting clarification of inadequate content. Requests may include “What do you mean?” “Which one?”, “Where?”, “I can’t do that” (or “I can’t”), “Do you mean X?”, and “That doesn’t make sense.” This part of the training can be great fun, with the facilitator making outrageous statements and ridiculous demands of the child as in a game of “Simon says.” I still remember the expression on the face of a child with Down syndrome whom I had asked to get into his lunch box. The SLP can insert intentional content inadequacies into any number of daily activities. Finally, the facilitator can teach the child to identify and react to messages that exceed his or her comprehension capacity by the presence of unfamiliar words, excessive length, and excessive syntactic complexity. This level of comprehension breakdown may be the most difficult to detect. A child can practice identification and reaction in the form of clarification requests in real-life situations in which these difficulties are likely to occur. Most novel activities include unusual jargon that the facilitator can use to confuse the message. For example, cooking offers such words as ladle, simmer, and skillet. Requests for clarification might include “Say those one at a time” (or “One at a time”), “That was too long for me,”“I don’t know that word” (or “I don’t know”),“Can you tell me a different way?”, “What does X mean?” (or “What do you mean?”), and “Can you show me?” (or “Show me”). As training progresses, the child should learn to identify the point of actual breakdown for the speaker. The child can be aided in identifying where the breakdown occurred through questions from the SLP. NAR RATION Language intervention with narratives may focus on the organization of, cohesion within, or comprehension of the narrative. The length and complexity of narratives is positively related to the amount

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of exposure to narratives in intervention (Gummersall & Strong, 1999). Modeling and practice are especially important. Specific targets will vary with the maturity of the child. Whether the training target is comprehension or narrative retelling, cohesion, or grammatical structure, it is important to control for the many variables that can affect a child’s performance. These may include but are not limited to the following (Boudreau & Larsen, 2004): of characters • Number line clarity • Plot of episodes • Number and complexity of utterances • Number resolution • Clear appropriateness • Age • Interest level It is also important to manage the external prompts needed by a child, such as the use of sequential pictures and verbal prompts, which can range from those needed to craft the narrative, such as “In the beginning . . . ” and “How did the story end?” to more open-ended prompts, such as “What happended next?” Narrative Structure Young children use a script-based knowledge organization system. Although older children and adults retain this system, they also use taxonomic or categoric knowledge for processing (Mistry & Lange, 1985). Scripts are sequences of events that form unified wholes. When this event sequence is placed in linguistic form, it is called a text, the basis of narratives. You’ll recall that narratives generally are organized by a story grammar consisting of a setting statement and one or more episodes that include an initiating event, a reaction by the main characters to the event, a plan, an attempt to respond to the event, a consequence or outcome to the event, and a reaction or an ending (J. Johnston, 1982; Stein & Glenn, 1979). Knowledge of episode structure forms a framework within which the child can interpret complex events and unfamiliar content. An SLP can facilitate development of internalized narrative schemes or story grammars through the following (Hewitt, 1992; N. Nelson, 1986b): 1. Involve children in organized activities, such as daily routines, to help them organize their own real-life scripts. Go over each event in a routine with children. 2. Use scripted play in which children enact everyday activities that gradually become more variable and less bound to the immediate context. 3. Read and tell real-life stories with clear scripts. The narratives can be based on the child’s experience. 4. Help children transfer from event-based to linguistic organization by telling them narratives with clearly structured story grammars and then having them dramatize the stories. These exercises may be performed orally with young children or in writing with older. Scripted play is especially useful with preschool and early school-age children and will be discussed in detail in Chapter 12. Initially, it is very important that the scripts describe familiar motivat-

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ing events, such as going to the market or getting ready for school. The script should be introduced and discussed prior to play, with expectations stated. Today, we’re going to play “shopping at the market.” How many of you have gone shopping with someone? Good. Whom did you go with, Tiera? Okay, and whom did you go with, Andre? Good. What do we buy at the market? Uh-huh. Yes. Good. I have some things right here. What’s this, Jewell? Good. What’s this, T. J.? Right. Do we buy this at the market? That’s right, we don’t buy this at the market. What’s this, Rochelle? Good. Do we buy this at the market? Good, that’s right, we do. What is the first thing that happens when you get to the market? (And so on.) The script is played and discussed afterward. With each replaying, the children change roles, modify the events, and use fewer concrete objects. As children become more adept at recounting the script, the SLP encourages telling of the narrative without an enactment. Again, familiar roles and situations are used. These procedures work especially well with groups of children and will be discussed in more detail in the following chapter on classroom intervention. The SLP can facilitate production of event descriptions by having children describe familiar events as they occur or as recalled from slides, pictures, or videotapes (Duchan, 1986b; Lewis, Duchan, & Lubinski, 1985). Children can role-play and describe familiar events as they occur. One of my favorite language lessons included mime and the acting out of familiar situations. Later, these events were described without role-playing. Pictures of familiar events from a child drawings can be used for sequencing. A facilitator can help the child identify the setting and characters by asking him or her to describe the picture; for example: Facilitator: Well, what do we have here? Child: This is me in the kitchen, and I’m making breakfast. Facilitator: So, we might say, “This morning, I was in the kitchen making breakfast.” What did you do first? (or Then what happened? or What’s this next picture?) After completing a step-by-step description, the child can be encouraged to tell the entire narrative. Episode knowledge can be taught through the use of children’s books. Book selection should be based on the following criteria (Naremore, 2001): event scripts • Familiar Pictures that support the episodes • Clearly sequenced • Appropriate lengthepisodes and language level • Stories “pretested” for retelling by the SLP • The actual story is not of prime interest. The SLP should select stories that contain all episodic elements. Intervention can begin with a mediated approach by discussing with the child the importance of stories for communication. After reading a book together, the SLP can help the child analyze the story following a “problemsolution-result” format. Learning structure is the goal. Terminology is not. The SLP helps the child break

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the story into pieces, identify the parts, and recombine them again into a cohesive narrative. For children who can’t relate to books, the SLP can construct one-episode narratives of experiences familiar to the child. Pictures and real objects may aid the child’s participation. Narratives can be retold repeatedly, although retelling is not the overall goal. Ideally, the child will internalized knowledge to use composing and comprehending conversational and book-based narratives (Naremore, 2001). Both narrative length and structure can be improved if children have a model on which to base their narrative and a structure inherent in the model, such as story retelling using pictures (Tönsing & Tesner, 1999). Retelling can begin with short stories of a few minutes’ length. If the story is longer, the SLP may choose only a segment for retelling. Generalization can be enhanced if the narrative is related to classroom content or to events in the child’s life. Pictures can be used to depict elements of the story grammar. With older children, an SLP can explicitly teach the elements of story grammar and use graphic story organizers to help children produce complete episodes. Stories retold many times can be retold by modifying one element that will change the outcome. Commercially available resources include The Magic of Stories (Strong & North, 1996), Narrative Tool Box (Hutson-Nechkash, 2001), and Storybuilding: A Guide to Structuring Oral Narratives (Hutson-Nechkash, 1990). Narrative telling can be extended in both speech and in writing. If a child is able to retell a story with two or three complete episodes, she or he is probably ready to begin composing original narratives (Naremore, 2001). This can be accomplished within a story context with the SLP supplying the supporting structure initially. The SLP begins a story and the child furnishes the final story grammar element. Gradually, the SLP supplies fewer episode portions. In each narrative, the child completes the story by supplying the final elements until he or she can compose an entire narrative. The teaching of longer written narratives will be discussed in Chapter 13. Children then can progress to factional narratives or their own original stories. The facilitator can use questions to move children to more sophisticated ways of organizing and expressing concepts and relationships. Chapter 12 includes a discussion of replica play and narratives in the classroom. Narrative discourse is the next logical step. Children should have the opportunity to practice forms of narration within a variety of role-playing situations (Heath, 1986). Narratives can be cued by statements such as, “Tell me what you did at . . . ” or “Tell me how you did . . . ”. Cohesion It is best to teach story grammar structure prior to cohesion (Liles, 1990). Although the two are related, it is possible for a narrative to have a good story grammar and poor cohesion. Contextualized training can provide the structure needed to foster the development of cohesion. Cohesion requires some metalinguistic skill because the narrator must pay attention to the text apart from the sequence of events being presented. Cohesion is of five types: conjunctive, referential, substitutive, elliptical, and lexical. (Lexical cohesion, using terms such as yesterday, in the future, prior to, and ate/will eat, is difficult to measure reliably and is very individualized. It will not be discussed here.) Conjunctive reference is the easiest form of cohesion to teach. Children’s oral narratives can be collected and transcribed into a “book.” Use of conjunctions and the relationships expressed can be analyzed. Simple stories containing various clausal relationships also can be read to children. In a retelling, a child usually will not express relationships and conjunctions that he or she does not use. Once a child’s narrative relationships and conjunctions have been analyzed, the SLP can begin to introduce other conjunctions. A developmental order of introduction may be helpful, although the first

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priority should be conjunctions omitted or used incorrectly in the relationships expressed. For example, in “ . . . stoled all his money. He robbed a bank. He was starving . . . ,” cause and effect are suggested but without the use of because. The SLP can introduce narrative relationships with or without a conjunction and then, using a question-answer technique, prompt a child to produce the desired conjunction. If the child responds incorrectly, the SLP can reread or retell the relevant portion of the narrative, model a response including the conjunction, discuss the meaning, and prompt the child to respond again. The important aspect of the training is an understanding of the relationship expressed, not a regurgitation of the correct conjunction. The final stages of training would include original narratives produced by the child. Referential cohesion uses nouns, pronouns, and articles to designate old and new information in the narrative. Questions and answers can be used to direct the child as a narrative is told. Retellings by the SLP might use a fill-in-the-blank technique, in which the child provides the appropriate word. Gradually, less narrative-structured and more expository materials can be introduced. It is more difficult to comprehend and produce cohesion without the narrative frame. Comprehension Narrative comprehension can be improved by beginning with predictable narratives concerning everyday events or routines familiar to a child. The child’s internalized event script aids both comprehension and recall. As in scripted play, variations in the narrative are introduced gradually, and the text moves to more unfamiliar and fictionalized events and stories. Comprehension and recall can be facilitated by having children draw or write common event sequences. Before beginning a narrative, an SLP should review it with the child. Help the child bring his or her knowledge to the task. This prenarration task is discussed in detail in Chapter 12. Data suggest that the use of subjectivity or the character’s thoughts and feelings can enhance comprehension of fictional narratives (Hewitt, 1992). Children can be taught to focus on a character’s reactions as a way of making sense of the events in the narrative. Thus, the child focuses more on the reasons for and outcomes or results of events within the narrative. There are no right or wrong answers; rather, the child’s responses explain events in a manner comprehensible to the child.

Semantics Semantic intervention consists of several different but related levels of intervention. Word meanings form relationships with other words that help categorize and organize not only the language system but also cognitive processes, particularly for older children. For this reason, semantic intervention involves a variety of interrelated intervention strategies much more complex than simply training vocabulary words. At its core, word meaning consists of concepts or knowledge of the world. Words do not name things, but rather refer to these concepts. These conceptual complexes are formed from many experiences with the actual referents or with conversational or literary use of the words. The process of forming and organizing concepts may reflect general cognitive organization and, in turn, influence that organization (N. Nelson, 1986b). Semantic training must recognize the importance of these underlying concepts and include cognitive aspects of concept formation. Several commercial resources are available for training cognitive skills essential for conceptualization (Cimorell, 1983).

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I NADEQUATE VOCAB U LARY Reference, or meaning, is the relationship of a sign or word to the underlying concept. Different strategies are used by different children and by the same child at different developmental times to construct meanings. Children with LI often use one strategy exclusively or predominantly. For example, the meanings expressed by some children with ASD seem to be unanalyzed, situationally related “chunks.” Children with ID are often deficient in their ability to form complex concepts. Other children may have conventional concepts but experience difficulty relating these underlying concepts to linguistic symbols or words. An SLP may assist with the building and extending of individual reference systems by providing situations in which children encounter the physical and social world. Dynamic events seem to encourage early concept development better than do static ones (N. Nelson, 1986b). Therefore, feature learning can be enhanced by focus on movement, contrast, and change. The most successful strategy is to (a) build on an experiential or prior knowledge base and establish links to new words, (b) teach in meaningful contexts, and (c) provide multiple exposures (Nagy & Herman, 1987). The experiential base is important, especially for the child below age 7. The child should have the opportunity to have meaningful, real experiences. For example, play in the snow could be by a lesson finding on the words used in the activity. As mentioned previously, repeated input and practice retrieval are beneficial for vocabulary teaching with children, especially those with Down syndrome (Chapman et al., 2006). World knowledge, or what the child knows about her or his world, is very important for vocabulary growth. Early word meanings are acquired within event-related experiences, especially predictable, everyday routines and their accompanying scripts (N. Nelson, 1986b). Gradually, meanings generalize and decontextualize. Between ages 5 and 9, the child developing typically reorganizes her or his vocabulary from event-based processing to more linguistic, semantic-based processing. Groups of children on a field trip can experience the world by touching, smelling, and even tasting an old log and describing the sensation. Language facilitators can encode features of events and entities to which children attend (N. Nelson, 1986b). Older elementary school children can learn from the experiences of others, much as adults do. Exposure to storybook reading has been shown to be an effective way for kindergarten children to learn new words, especially those children with poor vocabularies (Justice, Meier, & Walpole, 2005). To be effective, reading should be paired with other word-teaching strategies, such as explaining an unfamiliar word when it occurs in the story, offering synonyms, acting out the word, and pointing to the referent. Vocabulary is acquired in a two-phase process. First, words are fast-mapped—a small portion of the meaning is acquired on the first exposure. A child’s world and word knowledge affect which features of the definition she or he acquires. The second phase is a later, more gradual one in which repeated exposure results in a more complete map of the word’s meaning. Children and adolescents with LI need to learn how to use the context to establish word meaning (McKeown & Curtis, 1987; Nippold, 1991; Sternberg, 1987). Contexts provide a number of cues that can be classified as temporal (time), spatial (location), value (relative worth), stative descriptive (physical description), functional descriptive (use), causal (cause and effect), class membership (type), and equivalence (similarity/difference). Class membership and functional descriptive are the easiest for children, whereas stative descriptive seems to be the most difficult (Sternberg, 1987). Context should be established for the child prior to introducing the word numerous times. A child will need help in determining what he or she knows from the context and repeated exposures in a vari-

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ety of play or interactive contexts. Novel word learning is enhanced when words receive emphatic stress while being presented within stimulus sentences (Ellis Weismer & Hesketh, 1998). Stress is important given the difficulty children with SLI have in using syntax to acquire vocabulary (Rice, Cleave, & Oetting, 2000). In this format, meaning, use, and word class (i.e., noun and agent) membership coalesce. Narratives also may provide a context for introducing a novel word (Crais, 1987). In vocabulary training with children with SLI, a mand-elicited imitation (MEI) model is reportedly a better teaching method than focused stimulation alone (Kouri, 2005). In the MEI method, nonverbal cues, such as the presence of toys, and verbal cues, such as “What do you want?” are used to elicit requests from children. If a child does not request an item by name, the SLP can give an imitative prompt. For children with SLI, different teaching cues seem to affect learning in differing ways (Gray, 2005). For example, semantic cues (It’s made of wood) foster comprehension, while phonological cues (It begins with /s/) aid expression. Because children with poor vocabularies can have difficulty with both the phonological and semantic aspects of words, intervention with both should be explored (Nash & Donaldson, 2005). Overlearning of new words in both expressive and receptive mode seems warranted, especially for children with SLI (Gray, 2003). Several factors may influence new word learning. For example, children acquire new words more readily if they consist of frequently occurring phonemes in common word locations, if the attached morphology, such as plural -s, is not modified between the learning and testing phases, and if the novel word is presented before the referent is shown (Bedore & Leonard, 2000; Storkel, 2001; Storkel & Morrisette, 2002; Tomasello & Cale Kruger, 1992). In general, access paths to words for both TD children and those with LI become strengthened with successful use. For this reason, difficulties in accessing words by children with LI may prevent them from developing strong access paths to these words. In general, expressive use and retrieval among all 7- to 12-year-olds is positively influenced by a child’s greater familiarity with the word and its neighborhood, or area of morphemes that differ by one phoneme; greater familiarity with the word’s lexical neighbors; lower neighborhood density, or lower number of lexical neighbors; and greater similarity between the word’s stress patterns and those of the language spoken (Newman & German, 2002). Four different methods of vocabulary teaching are recommended (Alderete, Frey, McDaniel, Romero, Westby, et al., 2004): in interactive book reading • Engaging Direct vocabulary instruction • Teaching word-learning strategies for using morphological knowledge • Fostering word consciousness through “playing with language” • In interactive reading, children can be encouraged to immediately talk about objects, characters, and events and also to expand to more nonimmediate talk that goes beyond the text. Blank, Rose, and Berlin (1978) offer levels of abstraction that progress away from the immediate text. Immediate prompts ask children to point to, name, and describe by physical traits. Reordering their perceptual skills, children are asked the meanings of words used in the text, identifying characters and events by less perceptually based descriptions. Finally, children reason in response to questions about why events occurred or why emotions developed. After-reading activities can focus on discussion of words from the text and their meaning in context. Direct vocabulary instruction should focus on high-frequency words, especially those used in the classroom and essential for success. Words can be taught through a variety of methods and across sev-

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eral situations, relating them to other words and building on the initial knowledge a child may possess. Within reading activities, words can be contextualized to aid learning. Multisensory approaches in which the child both listens to and produces the word will help to form a phonological representation. SLPs should provide examples from other contexts and encourage the child to do likewise. Word-learning strategies focus on morphology, teaching root words and various morphological affixes. This intervention can be combined with spelling instruction; etymology, or dividing words to discover their meaning; and sorting words by morphological affixes. Perhaps the most fun comes in fostering word consciousness, the final strategy. This involves word play, matching synonyms, riddles, art, drama, and poetry. This can be especially fun using figurative words and phrases. Children also enjoy creating words that do not exist in the dictionary or giving existing words new definitions. Such original words can be used along with real words to try to encourage children to make educated guesses about the meaning (Atkinson & Longman, 1985; Hall, 1984). Table 11.4 contains several original words. In a recent conversation, English-as-a-second-language learners used the word skinship, which they defined as the relationship between family members who touched frequently. No one likes to give verbatim definitions. Learning benefits if a child and facilitator can use the word to discuss a relevant topic in context. It is important to remember that the child may not need a full adult definition when the word is first introduced. A less full definition may suffice (Kame’enui, Dixon, & Carnine, 1987). The facilitator should not expect dictionary definitions from children below age 12. By that age, however, a child developing typically should be able to define words, draw conclusions, and make inferences. Child and adult definitions, especially categorical ones, seem to be organized around a prototype or best exemplar. Examples given to a child should be of the prototype, or best exemplar, variety, as these will enhance learning of salient features. In addition, the SLP should expose children to multiple examples of events and things in familiar contexts in order to perceive these features of events and entities. Language facilitators can act as mediators, framing, focusing, and providing salient features of experiences for the child (N. Nelson, 1986b). Within activities, children can be encouraged to describe features. Descriptors then can be used to determine similarities and differences and to label the world. Instead of naming unfamiliar entities

TABLE 11.4

Examples of Sniglets

Sniglet

Definition

Bathquake

n. The violent quake that rattles the entire house when the water faucet is turned to a certain point.

Lotshock

n. The act of parking your car, walking away, and then watching it roll past you.

Maggit

n. Any of the hundreds of subscription cards that fall from the pages of a magazine.

Petrool

n. The slow, seemingly endless strand of motor oil at the end of the can.

Shoefly

n. The aeronautical terminology for a football player who misses the punt and launches his shoe instead.

Source: Adapted from Hall (1984).

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such as types of leaves, children can be encouraged to stretch their existing language and give descriptive names, such as five-pointed leaf tree. Facilitators also can target words used frequently at home and school in everyday activities and events. In general, it is easier to learn words for known concepts than to learn both words and concepts (Crais, 1990). The choice of which words to teach should be based on the likely frequency of use, typical development, need within the classroom and use in textbooks, and likelihood of the child learning the word from context alone (Graves, 1987). Even slang expressions might be taught to aid socialization, especially among adolescents (D. Cooper & Anderson-Inman, 1988). Training should include words along with others that mean the same (synonyms), sound the same (homonyms), or are opposites (antonyms). This training will help the child organize language for easy storage and retrieval of information. Prefixes and suffixes are also important, as is syllabication. A child’s existing meanings can be consolidated by building on the child’s current vocabulary while correcting errors and misconceptions of meaning (Elshout-Mohr & van Daalen-Kapteijns, 1987). Understanding and training should progress from these general meanings to more specific ones. It is important for a child with LI to expand meanings beyond the often obvious best exemplars. Training also should proceed from more contextual meanings, as in “hit the ball,” to less contextual, more figurative meanings, such as “hit the roof,” and multiple meanings, such as “a hit musical.” Multiple meanings should be related to specific academic subject areas or contexts. The facilitator should help the child understand that meaning varies with context (Graves, 1987). Referents should be presented in a variety of ways to build a total concept. Varying contexts provide for maximum usage and exposure. Storytelling in which a novel word must be used is also a good strategy and uses context to facilitate use. Words stored without sufficient semantic knowledge are vulnerable to retrieval failure, leading to word-finding problems (McGregor, Newman, Reilly, & Capane, 2002). The semantic features of words can be analyzed to expand the characteristics associated with words and to aid categorization (Crais, 1990). Words can be classified according to their semantic features, as in Figure 11.1. Sorting tasks perform a similar function, and children can be encouraged to make their own associations. A root-word strategy can be used with school-age children to help them discover meanings and their modifications (Crais, 1990). Suffixes are easier to learn than prefixes and should be introduced first (see Morphology section of this chapter). Prefix training should begin with concrete, easy-todefine prefixes, such as un-, and proceed to more abstract ones. The most frequently used prefixes in American English are un-, in-, dis-, and non-. Many commercially available games can be used as is or modified for vocabulary training, including Boggle, Pictionary, and Scrabble (Beck, McKeown, & Omanson, 1987; Graves, 1987). Semantic organizers, such as spidergrams, can be used to build associations. Children can use semantic organizers to “brainstorm” or to tell all they know about a word (C. Nelson, 1991). Figure 11.2 is a typical spidergram. SE MANTIC CATEG OR I ES AN D R E LATIONAL WOR DS Meanings extend beyond the word level. As children develop beyond single-word utterances, they are able to encode meaning in the form of the utterances produced. Words fulfill different semantic roles, such as agent and action, that specify the relationships among those referents. Thus, a child forming a sentence must keep in mind both the referent and the semantic role.

Part 3 Intervention

Transportation

Motorcycle Bicycle Car Bus Train

Four-Wheel

X X X X X

PedalPowered

X X X X

Bird

On Farm

X X

X X X

X X X

X

Wild or Zoo Animal

Gives Milk

Four-Legged

X X X

X X X

X X FIGURE 11.1

Runs on Rails

X

X X

Animals

Chicken Duck Cow Elephant Goat

EnginePowered

Two-Wheel

X X

Analyzing somantic feature similarities.

Words and phrases also modify the meaning of basic sentence elements by indicating qualities, such as perceptual attributes (big, old), manner (quickly), temporal aspects (first, later), and relationships between larger sentential units, such as additive (and) or causal (because). As a listener, the child can only comprehend other people to the extent that she or he understands the various relationships underlying their utterances.

ech spe ke s

r

ade

Ma

tar

ili fm

eo

hite House y

arg

ch

gton

es

Lives in W

In

In W ashin

Le

Speaks on television

PRESIDENT ties ents

eo

ple

ry

unt

Meets o ther presi d

db

yp

f co

gn

cte

do

FIGURE 11.2

Ele Hea

sl aw s

s trea

Sign

Si

304

Spidergram of word meanings and associations.

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Semantic Classes An SLP can teach words to children while placing the words in different semantic classes. A portion of word definition is the semantic class into which a word can be placed. The SLP also can teach other word types that relate to that class. Children with LI may find it difficult to use certain semantic classes of words. The agent function usually found in the subject position of a sentence offers a unique example for semantic category training (Connell, 1986b). English is a subject-prominent language in which a large number of elements are associated with the subject of the sentence. These elements include subjectverb agreement, as with variations of the verb to be (am, is, are) and the third-person singular, present tense -s ending; pronouns; and auxiliary verb-subject inversions in questions. These elements, while important syntactically, are not critical to the content of a sentence, and they can be omitted without greatly affecting the understanding of the sentence. For example, “Mommy eat soup?” gets the general meaning across. An SLP may facilitate teaching these elements by teaching the concept of subjecthood (Connell, 1986b). The SLP can accomplish this by using a functional approach in which he or she teaches the child the purpose of a subject. The function of a sentence’s subject, represented by a noun or a noun phrase, is to designate the perspective used in the sentence. In contrast, the topic designates the focus of the conversation. If the sentence contains action, the agent designates the actor. In the sentence “John ate the cheeseburger,” all three elements are the same. In the passive sentence “John was arrested by the police,” John is the topic and the subject, but police is the agent. Subjects can be identified by the pronouns used with them. Subjects take nominative case pronouns (I, you, he, she, it, we, you, they), whereas topics and agents may take different types. Subjects also agree with predicates or verbs (he walks, we walk), whereas topics and agents need not. The SLP can train children to identify the topic and the subject by using the following forms (Connell, 1986b): 1. Nominative case pronoun (He 2. Objective case pronoun (Him,

+

+

be is

nominative case pronoun he

+

+

verb/adjective/adverb/noun running) be is

+

verb/adjective/ adverb/noun running)

The first is taught in response to a “Which one is . . . ?” type of question, and the second in response to a “What is the man doing?” or “Who is . . . ?” type of question. Children can deduce the function of the subject and its separateness from the topic by the varying contexts in which they are used. Children can learn each sentence form by imitation and then in response to questions within ongoing activities. Training should begin with the first sentence type because it is included within the second. Once children have learned the formats, the questions can be alternated. Later, the habitual or simple present form of the verb, such as eat or drink, can be introduced to teach children subject-verb agreement within the same subject-highlighted format. Other semantic classes may be taught in a similar manner. Table 11.5 presents suggestions for training. Question cues can help children identity the semantic class of different words within a variety of activities.

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TABLE 11.5

Suggestions for Training Semantic Classes

Instrument Initially, this class can be trained in the final position of the sentence, preceded by the word by, as in “The wood was split by his axe.” Position and the preposition by act as signals for this class. This class can also be signaled by the verb use, as in “John used the rake to gather the leaves.” This sentence type can be prompted by questions such as “How did. . . ?” and “What did John use to. . . ?” Patient/Object This class may be taught initially by using the final position in the sentence as a direct object to transitive verbs. Question prompts such as “What did Carol throw?” may be used to elicit this class. It is somewhat more difficult to teach this class in the subject position because that position is usually occupied by an agent. If agents are taught in response to a who type of question, patients might use what, as in “What grew in the park?” Dative The dative class is most frequently and obviously used as an indirect object. This function can be clearly signaled initially by use of the prepositions to and for. Question prompts can include these cues and the word whom, as in “For whom did Mary buy the flowers?” Temporal, Locative, and Manner These classes are relatively easy to teach because each has specific questions that prompt usage. Prepositions, such as in, on, and at, are used with these functions, as are to, with, and by, which are used to mark other semantic class use. Accompaniment The final position in the sentence and the preposition with should be used in training to signal this class. A with whom question prompt can be used to elicit response.

Relational Words Relational words fulfill many functions in language. Relationships may be based on quantity or quality and may be general or specific. Other relational words are used to mark location and time. Conjunctions are relational words that relate one clause to another. Each type of relational word requires specific intervention considerations. In general, relational terms can be acquired through descriptive tasks, in which a child must differentiate between one entity and another, or through narrative tasks, in which a child must aid the listener to differentiate characters. An SLP can help the child initially by keeping the task context-bound and by controlling the number of items or characters. By playing dumb or acting confused, the facilitator can help the child provide additional or essential information. Narratives are also effective vehicles for acquiring conjunctions, especially when the facilitator synthesizes larger, more conceptually complex sentences based on those of the child. Quantitative Terms A child does not need to be able to count to learn quantitative terms. Initial training can begin with the concepts of one and more than one. The second concept can be marked variously by many, much, some, and more. Such terms as these and those should be introduced with some caution because of deixis, or interpretation from the perspective of the speaker.

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The distinction between many and much is complex and should be ignored with children functioning at a preschool level. In general, many is used with regular and irregular plural nouns, such as cats, shoes, and women. In contrast, much is used with mass nouns—nouns that refer to homogeneous, nonindividual substances, such as water, sand, and sugar. It is not surprising that children have difficulty with the two terms much and many. Before going beyond the quantity words mentioned, the child must learn to count and have a concept of the relative values of different numbers. In other words, the child must know that 4 is greater than 2, not that 4 merely follows in a sequence. Later quantifiers can include words such as few and couple. These can be followed by other quantifiers, such as nearly, almost as much as, and half. Table 11.6 presents common quantitative words. The ordering of these words in the noun phrase is very important and is discussed in the syntax section of this chapter. Quantitative terms can be taught within many naturally occurring situations, using anything from counting blocks and Legos to candy and treats. Books and many fingerplays also contain counting. Narratives can contain several characters (e.g., friends, animals at the zoo, clowns) or objects (e.g., tools, food) that can be grouped in various ways throughout the story. It is also easy to create situations in which children request a number of objects. Quantitative terms also naturally occur within any place that replicates commerce, such as a fast food restaurant or market. Qualitative Terms Qualitative terms include such words as big and tall, plus bigger and tallest, which use the -er and -est morphological markers, and such phrases as as big as, not as wet as, smaller than,

TABLE 11.6

Common Quantitative and Qualitative Terms

Quantitative

Qualitative

One, two, three, four . . . Many, much, lots of Some, few, couple More, another Nearly, almost all As much/little as Plenty Half, one-fourth, two-fifths 10%, 75% Units of measure: inch, foot, mile, cup, pint, quart, gallon, centimeter, meter, kilometer, liter, ounce, pound, gram, kilogram, acre

Big, little, long, short Large, small, fat, thin Soft, hard, heavy, light Same, different, alike Old, young, pretty, ugly Blue, green, red. . . . Hot, cold, warm, chilly Wide, narrow Sweet, sour Nice, mean, funny, sad Fast, slow Smooth, rough Clean, dirty Empty, full Angry, afraid Comparative and superlative relationships: -er, -est, as x as, x-er than

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and the like. Table 11.6 presents common qualitative terms. In general, children learn to use the comparative -er before the superlative -est, and training should follow that pattern. It is best to begin with the regular use of these two markers before introducing exceptions, such as better and best. Words can be expanded into phrases, for example, from bigger to bigger than. Children seem to acquire concepts one semantic feature at a time. A corollary to this hypothesis is that broad, nonspecific concepts (e.g., big) are learned before more specific concepts (e.g., long). In this example, big refers to overall size, whereas long refers to size only in the horizontal plane. The SLP should introduce terms and relationships in the order in which comparative terms develop. Table 11.7 includes common pairs of comparative terms and the approximate age at which most children can use them correctly. In general, conceptual word pairs are acquired asymmetrically. Children ages 3 to 7 appear to learn the positive member of conceptual pairs, the one that represents more of the dimension characterized by the pair, prior to learning the negative member (Bracken, 1988). For example, big and little are opposite poles of the dimension size. Big represents more size and is, therefore, the positive member. These data suggest that positive members should be taught first to children with LI. In addition, positive-type comparisons should be taught before negative ones. In other words, bigger than should be introduced before smaller than and not as big as. Positive comparisons seem to be easier for children to process. Many play situations and narratives include qualitative terms. It is also easy to devise conversations in which children must contrast one thing with another. By acting confused and asking “Which one?” a facilitator can elicit responses such as “The big one” or “The green fuzzy one.” Within several

TABLE 11.7

Common Comparative Word-Pairs

Positive-Negative (age)

Positive-Negative (age)

Positive-Negative (age)

same-different (36–60 months) in front of-behind (48–54 months) into-out of top-bottom (48–54 months) rising-falling healthy-sick big-little (30–48 months) deep-shallow thick-thin hard-soft (30–42 months) smooth-rough more-less (42–72 months) all-none old-new before-after (66–72 months) open-close

inside-outside over-under (42–48 months) front-back (48–52 months) above-below (66–72 months) right-wrong heavy-light (30–48 months) tall-short (30–84 months) loud-quiet sharp-dull solid-liquid full-empty (36–48 months) with-without (48–54 months) arriving-leaving first-last (60–66 months) on-off (24–36 months) up-down (36–60 months)

high-low (42–60 months) forward-backward happy-sad old-young large-small (78–84 months) long-short (horizontal) (54–60 months) hot-cold dark-light tight-loose a lot-little fast-slow early-late always-never

Note: The overall order does not reflect the order for teaching conceptual pairs. Source: Bracken (1988); Edmonston & Thane (1990); Wiig & Semel (1984).

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situations, such as play or snack, children can be offered choices based on some contrasting feature, such as size or color. Spatial and Temporal Terms Several words are used to mark both space or location and time and, thus, are potentially confusing. Among the most commonly used words in English are prepositions, such as in, on, at, and by. Each of these small, seemingly insignificant words has several definitions. In the Syntax section of this chapter I discuss prepositional training. In addition, other words, such as first and last, also note place and time. Spatial concepts are best taught first in relation to the child; then with “featured” or fronted objects, such as a television, chair, or person; and finally with nonfeatured objects, such as a wastebasket or a ball (Edmonston & Thane, 1990). The latter is more difficult to learn because it involves deixis, or interpretation based on the speaker. In general, vertical dimensions (on top) are learned before horizontal. Horizontal front and back terms, such as in front of and behind, are learned before horizontal side-to-side terms, such as beside and next to. The order of temporal term learning reflects the underlying concepts of order, simultaneity, and duration (Edmonston & Thane, 1990). Terms that denote order, such as before, after, first, and last, usually are learned before terms for simultaneity, such as at the same time, during, and when. Duration terms, such as a long time, generally are acquired last. In general, it is better to begin with concrete definitions and progress to more abstract ones. For example, with first, last, before, and after, training can begin with objects in a line or with a train. The facilitator can have the child touch individual objects, then a short sequence of objects (first, last) and finally a reverse sequence (Touch first after last.”). Sequencing objects should be used before terms for sequencing events and the concept of time sequencing. One context is not enough for teaching concepts of space and time. The greater the number of contexts, the more learning and generalization that will occur. Language can be used to help a child organize the environment by marking experiences of space and time. Table 11.8 includes common spatial and temporal terms. The SLP can use direction-following games and activities to train children about space and time. It might be best to begin with routines that the child knows, such as those that occur at home or in the

TABLE 11.8

Common Spatial and Temporal Terms Spatial

next to before after on, on top in, into in between between middle above

under over below corner bottom inside outside side end

Temporal

in front of behind beside right left through high, tall upside down together

next before after in, to soon later now above yesterday

today tomorrow calendar dates months seasons numerals for years morning afternoon evening

days weeks hours minutes through away from toward sometimes

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classroom, and then move into less familiar activities, such as using a pay telephone or changing a tire, in which the child must rely more on linguistic input. Actinities involving making or cooking are excellent. Later, the SLP can use sequenced pictures or storytelling in the training. Pictures may seem very abstract to some children, especially school-age children with ID and preschoolers, and should be used with caution. Children can identify what happened first, next, and last. Deixis and the use of deictic terms are very difficult concepts to teach. The facilitator who takes both the role of speaker and prompter for a child violates the roles in a conversation. The simple example of here and there is illustrative. The request “Put the ball here” is said from the speaker’s perspective. To the listener, the speaker’s here is most likely there. If the speaker then shifts to the listener’s (the child’s) perspective and says, “Yes, put it there,” it may confuse the child further. How can it be both here and there for the speaker? When training the child about deictic terms, it is best to sit next to the child so that you can share a perspective. From this shared perspective, deictic terms for location would be similar. Another facilitator, puppet, or prerecorded tape may act as the other conversational partner. The teaching of deixis is discussed also under the topic of pronouns in the Syntax section of this chapter. Conjunctions An SLP should teach conjunctions in the order in which they develop by noting for a child the relationships expressed in each (Klecan-Aker, 1985). For example, because represents cause and effect and may not be fully acquired until about age 12. Table 11.9 presents the general order of conjunction acquisition. The conjunction and can first be taught to combine entities, as in “cats and dogs.” In a cooking activity, the facilitator might say,“Which two types of cookies do you like best?” or, “Tell me your two favorite types of cookies.” In similar fashion, but can be used for like/dislike distinctions (“I like cookies, but not beets”). A clause + conjunction + clause format can be employed initially to help the child acquire the underlying relationship. For example, sentences might be presented as follows: We wear a coat because it is cold. We wear a coat if it is cold. We wear a coat when it is cold. Once a child understands these relationships, the order of the clauses can be reversed, as in “Because it is cold, we wear a coat.” Next, the SLP can present clauses for the child to combine. The breakdown and buildup technique, described in Chapter 10, may be used to help the child identify clauses and conjunctions and then reconstruct the sentence (Klecan-Aker, 1985). Conjoining clauses with conjunctions is a natural occurrence within narratives and can be prompted through storybook retelling or with pictures. The SLP can reply to a child’s utterance by supplying the desired conjunction and then asking for a restatement as in the following: Child: Adult: Child: Adult: Child:

And the whole bridge fell down. Why? Because . . . ’Cause the water was going so fast. That sounds very exciting. Tell me the whole thing again. The bridge fell down because the water was going fast.

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Adult: The bridge fell down because the water was going fast. That’s scary. What happened next? WOR D R ETR I EVAL AN D CATEG OR IZATION Word-finding difficulties can result from two possible sources (Kail & Leonard, 1986). The first is lack of elaboration or lack of a well-established, thorough representation of the word within the child’s internal dictionary, or lexicon. Word knowledge is related to storage ability in that growth in word knowledge results in a larger storage capacity. An increased lexicon requires greater semantic networks in which to group words. In general, children who exhibit difficulties often have less extensive vocabularies and poor word knowledge (Kail & Leonard, 1986). The second source of problems is in retrieval. In general, children with this problem are less efficient in retrieving words from storage. Whereas elaboration difficulties may occur alone, retrieval problems usually do not and may be an additional difficulty found in some children with elaborative problems (Kail & Leonard, 1986). In short, children with poorly established word meanings have a semantic storage problem. In contrast, those with word-retrieval problems on words that they understand have poor retrieval skills. Finally, some children have problems in both areas. These last children should receive intervention services that combine the goals of the other two. A number of activities have been suggested that facilitate word-finding skills (McGregor & Leonard, 1989; Wing, 1990). Children appear to benefit from both elaboration and retrieval activities (McGregor & Leonard, 1989). Word-finding activities can be incorporated easily into a number of everyday activities and conversations about these activities. Prior to beginning intervention, it is important to determine the source of the problem (German, 1992). An SLP should derive naming data from a variety of activities to be certain of the cause of the problem. In general, children name real objects and colored pictures with a higher accuracy than blackand-white pictures (Barrow, Holbert, & Rastatter, 2000). Naming words in a meaningful context is also performance enhancing. Children with storage problems have difficulty understanding and retrieving words that are not stable in their memory. Inadequate storage is the result of shallow meanings, reference-shifting problems, and poor analytical and synthesizing skills (German, 1992). The goal of intervention is to improve word knowledge and storage. Those with retrieval-only problems have difficulty with search and recovery. Somewhere in the process of discriminating the desired word from among competing words and constructing the phonological specifications for production, the process breaks down (Bjork & Bjork, 1992). The goal of intervention is to improve access. Memory storage seems to be affected by the depth or level of processing. In general, recall is best for words processed at the deepest levels, which are elaborative by nature (Lockhart & Craik, 1990). Theoretically, acoustic processing, such as rhyming, is surface processing; categorical is mid-level; and semantic/syntactic is deep. Words are remembered in relation to other words and form meaning networks. Such relationships might be morphological (Nagy et al., 1989). When one member of the family is accessed, it activates others. These relationships are based on meaning, not just linear sound or letter strings. In other words, ride might elicit drive or pedal but not elicit stride, cad might elicit villain but not cadet. Semantic similarity and, to a lesser degree, phonetic similarity do affect judgments of relatedness. Networks of semantic-related morphemes are part of each individual’s memory system. Thus, stain, stained glass, and stainless steel are perceived to be related.

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TABLE 11.9 and and then but, or

Acquisition Order for English Conjunctions because so, if, when until, before-after

although, while, as unless therefore, however

Note: Data from studies are very variable, and this list is only a rough guide. Source: Based on Bloom, Lahey, Hood, Lifter, & Fiess (1980); L. Lee (1974); Wiig & Semel (1984).

Elaboration training focuses on organization of the child’s lexicon and generalization of word meanings to everyday use (Kail, 1984; Kail & Leonard, 1986). In children developing typically, increased word knowledge results in increased storage strength. In short, a larger vocabulary means a more extensive database. In elaboration training, an SLP can use semantic focus strategies, such as nonidentical examples and word comparison tasks. The SLP presents nonidentical examples of the word in several linguistic contexts, to enrich a child’s definition and word associations. Nonidentical examples for house might include dollhouse, housefly, and greenhouse. In comparative tasks, the SLP expects the child to identify similarities and differences between two words with related meanings, such as house and hotel. A mnemonic or “key word” strategy (Parente & Hermann, 1996) also might be used to aid elaboration and recall of new vocabulary. New words are linked with acoustically or visually similar words with which the child is familiar. For example, dogged might be linked with dog. This initial linkage is gradually modified by the child through use to a semantic one with deeper processing. Pictures and written descriptions may be used to link two words. A known word is used to aid learning and storage of an unknown one. In the above example, a dog would be portrayed being stubborn or determined (dogged). Under the picture, it might read The dog was dogged and would not give up. Other examples are given in Figure 11.3. The key word now becomes the retrieval cue. Children using this approach reportedly are able to recall 50 percent more definitions than those taught vocabulary by a more traditional method. In addition, the combined picture and sentence format appears to be more effective than either used separately (Condus, Marshall, & Miller, 1986). Children seem naturally to enjoy word games and word play, and these teaching strategies can be incorporated into many types of activities. As a communication partner, I like to get very “confused” and use words in silly ways. Children laugh and freely correct their somewhat slow-witted communication partner. Data from typically developing children suggests that taxonomic, or categorical, such as things to write with (crayon, marker, pencil), and thematic, or event, such as the act of writing (paper, pencil), relations develop differently and can affect word recall (Hashimoto, McGregor, & Graham, 2007). In addition, taxonomic relationships are originally based by children on observable perceptual features (shape, size). This data suggests that for preschool and kindergarten children thematic cues might assist word recall. Taxonomic cues should begin with obvious perceptual similarities. Retrieval training may include categorization tasks, such as naming members of a category or identifying the category when given the members. Categories include animals, clothing, grocery items, and the like. Categories also may be formed by the initial sounds of words and by rhyming. As a group, children with LI are less likely than children developing typically to discover semantic organization strategies on their own and usually require more examples to determine a basis for organization and for generalization of organizational skill. Word-retrieval errors should demonstrate

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Examples of mnemonic strategies.

the predominant organizational framework of the child and alert the SLP to the patterns that need strengthening. Categorization tasks, especially such familiar ones as Saturday morning cartoon shows, in which the child names members of the category, facilitate recall by building associational and categorical linkages between words. We usually recall a word by first accessing the category to which it belongs. Of course, the possibility still exists that a child will access the right category but retrieve the wrong member. Categorization tasks can be elaborative in nature when members of more than one category are presented together. For example, the items chair, bed, and table can be classified as furniture; chair, swing, and bicycle are things on which you sit; and bicycle, car, and bus are vehicles. The facilitator could present these items together and ask the child to classify them in as many ways as possible. Training might begin with actual objects and children making piles of objects that go together (Parente & Hermann, 1996). As a child, I sorted my comic books by main character and my baseball cards by team. Similar tasks are found in several everyday activities. Children can make collages in school of things that go together. After objects and pictures, then words can be used. Entities might be classified by description (e.g., cold) or by function (e.g., things that you ride on). The facilitator should encourage the child to use as many different sensory descriptions as possible to describe objects. Objects or toys, then pictures, and finally words can be sorted and then used to facilitate cognitive organization (Parente & Hermann, 1996). After sorting, a child can be asked to recall the categories. Once the child has recalled categories, he or she can be asked to recall members. Categories might include semantic/hierarchical groupings, perceptual similarities, and rhyming, spatial, and locational

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groups. Everyday tasks such as preparing grocery lists, organizing chores, or planning items to take on vacation or items that go in your backpack or your room have more relevance than arbitrary groupings. For example, prior to making a computer composite picture of the inside of a house, a child could identify objects to go in each room. Verbal training should begin with common words for everyday concrete objects (Nippold, 1992). Familiar everyday objects and events should be used. This notion is sometimes difficult for adults to understand, especially if they are attempting to bring interest and variety into the training. I am reminded of a teacher who tried to teach zoo and farm animal categories but found the children very unresponsive. Both categories were outside their realm of experience. When one child suggested the category of animals seen “squashed” on the highway, every child became a participant. Although the example is somewhat gruesome, the lesson for SLPs is very practical. Everyday natural environments provide specific cues that aid memory (Nippold, 1992). Word-retrieval difficulties can be helped by (a) naming/descriptive tasks (“It’s a bicycle; you ride on it by peddling”), (b) associational activities (“Red, white, and _____”), and (c) sentential elaboration tasks based on syntactic characteristics of two words drawn at random (“The trailer was parked near the restaurant while the driver ate”) and open-ended fill-ins and completions (“We eat with a _____”) that involve deeper levels of processing (Casby, 1992). Word-sorting tasks can aid in the development of categorization and recall skills. Taxonomy charts, especially for newly introduced classroom content, also can help children develop categorization strategies. Although semantic strategies appear to work well, they are not the only ones. With some children, a combination of phonological and perceptual strategies may also be effective (Wing, 1990), although semantic elaboration and retrieval activities produce better results than phonological strategies alone (McGregor & Leonard, 1989). In phonological training, the child participates in segmentation exercises such as rhyming, initial sound matching, and counting syllables and phonemes. The rationale for this method is that, in part, breakdown is the result of poor phonological representation of the word. Phonologically based treatment that focuses on words that begin with the same phoneme and words that sound alike can reduce semantic substitutions (McGregor, 1994). The child is trained to think about the first sound in the word when attempting to retrieve the word. Perceptual training involves imagery activities, such as simultaneous picture and auditory exposure, visualization with eyes closed, and silent name repetition. This procedure progresses to matching pictures to a “memorized” sample of names. The facilitator can help a child note perceptual and functional features and attributes that determine how members are categorized. The child with LLD will have particular difficulty abstracting salient features and, therefore, will have difficulty forming categories based on these features. One mediational strategy might be to teach the child to ask a set of questions to establish an association between a new item and something familiar. Questions might include the following (Parente & Hermann, 1996, p. 50): What does it look (sound, smell, taste) like? What does it mean the same thing as? What groups does it belong to? Who is it commonly associated with? It is important that children note a similar attribute on more than one object. Otherwise, children may begin to associate certain attributes with specific items. For example, several very different objects

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may be described as wet. This kind of task naturally leads to categorization. Attributes should appear also in many different linguistic forms, rather than just “It’s . . .” in order to enhance storage and memory. Categorical identification by a facilitator seems to be the best cue for recall when a child is stuck or blocks on a word. By naming the category, the facilitator can help the child locate the desired word more easily. Partial word cues also may help the child and are less confusing than synonyms. Sentence completion and nonverbal, gestural cues are also aids. Even the most effective strategies have limitations, suggesting that some children have severe deficiencies in the size, elaboration, or organization of their lexicons (McGregor & Windsor, 1996). Speed and accuracy of retrieval are important. In general, retrieval speed and accuracy are correlated (German, 1990, 2000; Guilford & Nawojczyk, 1988; Wiegel-Crump & Dennis, 1986). In children developing typically, speed and accuracy improve with maturity. Retrieval using picture cues is easier than naming to a descriptive cue. Naming to a rhyme is the most difficult (Wiegel-Crump & Dennis, 1986). Several retrieval strategies are listed in Table 11.10. In intervention, retrieval units should move from single words to discourse. As mentioned previously, it is important to keep in mind the “What’s the point?” criterion. The relationship of responses to naming exercises and word finding in conversation is unknown. Overall, responses to pictures may be of relatively little value. At a minimum, it is essential that training include a strong conversational element to ensure generalization of word-finding skills (Dennis, 1992). It may be helpful to teach a child strategies for circumventing word blocks (German, 1992). Synonyms, category names, and multiword descriptions may enable the child to continue the conversation and to work through the word-retrieval difficulty. Compensatory programming, such as modifying classroom tasks, also may aid the child with word-retrieval difficulties (Table 11.11). It is essential that those in the child’s home and classroom modify expectations and cue the child in the most advantageous manner. COM PR E H E NSION Very young children, lacking good word definitions, use their knowledge of familiar event sequences to structure their responses (Paul, 1990). As mentioned previously, familiar events provide scripts that aid comprehension and participation. Even later, when children and adults rely on lexical and syntactic cues, it is still easier to comprehend information in familiar events and contexts. In early preschool, a child matures from reliance on the immediate context to reliance on stored experience for interpretation. This stored experience is called world knowledge. The child uses world knowledge to structure a “probable event” strategy of interpretation. Only gradually does the child gain the ability to rely more on word order. By late preschool, ages 31⁄2 to 5, word order is used more consistently for interpretation (TagerFlusberg, 1989). Linguistic knowledge becomes the preferred comprehension strategy, although no clearly dominant strategy is evident. Preschoolers still rely more readily on contextual knowledge. It is not until ages 5 or 6 that children use syntactic and lexical interpretation more consistently (Keller-Cohen, 1987). They still make errors, of course, usually by ignoring clausal boundaries and interruptions in the flow (Wallach & Miller, 1988). By ages 7 to 9, children are more sensitive to boundaries, embedding, and temporal connectives. Children with a range of LIs perform similarly on language comprehension tasks (Bishop, 1982). They exhibit poorer comprehension than their peers developing typically (D. Bernstein, 1986; Nippold, 1985; Spector, 1990). In general, there is a greater tendency among school-age children with LI to rely

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TABLE 11.10

Word-Retrieval Strategies Retrieval Strategies

Attribute cuing

Phonemic cuing

The initial sound, vowel nucleus, digraph, or syllable is used to cue the target word.

Semantic cuing

The category name or function is used to cue the target word.

Graphemic cuing

The graphic schema is used to cue the target word.

Imagery cuing

A revisualization of the referent is used to cue the target word.

Gesture cuing

The motor schema of the target word action is used to cue the target word.

Associate cuing (story for book) Semantic alternates

An intermediate word is used to cue the target word. Synonym/category substitutions

Semantic components (synonym or category words) are substituted for the target word.

Multiword substitutions

Semantic components (functions or descriptions) are substituted for the target word.

Reflective pausing

Constructive use of pausing is used to reduce inaccurate competitive responses.

Remedial Strategies

Stabilization of phonological specifications

Rapid naming

Description

Description

Rehearsal

Students practice saying or writing the target words five times alone and then in five different sentences.

Rhythm + rehearsal

Each syllable is marked with a tap during the above rehearsal of the target word.

Segmenting + rehearsal

A line is drawn between each syllable during the above rehearsal of the target word. Students rapidly say names of and phrases with target words until their response time is reduced.

Source: German, D. J. (1992). Word-finding intervention for children and adolescents. Topics in Language Disorders, 13(1), 33–50. Reprinted with permission.

solely on word-order strategy and to retain this strategy longer than do children developing typically (F. Roth & Spekman, 1989a). Preschool children with LI overuse word-order strategies earlier and use of world knowledge less than their TD peers (Lord, 1985; Paul, Fisher, & Cohen, 1988; Tager-Flusberg, 1985). As a result, the comprehension strategy is less flexible and there are fewer alternative strategies than in children devel-

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TABLE 11.11

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Oral Questioning Modifications for Word-Retrieval Problems

Word-Finding Profile

Content Areas

Difficulty retrieving specific All words: inaccurate namer

Classroom Activity

Oral questioning

Recommended Modifications for Teacher

1. Use multiple-choice frames 2. Accept volunteer participation only 3. Provide target word cues (e.g., initial sound, syllable)

New Materials

Advance organizer

4. Use questions that require yes/no or true/false response Difficulty retrieving specific All words: slow namer

Oral questioning

1. Prime student for questioning 2. Give student additional time to answer

List of possible questions

3. Use multiple-choice frames 4. Use questions that require yes/no or true/false response Source: German, D. J. (1992). Word-finding intervention for children and adolescents. Topics in Language Disorders, 13 (1), 33–50. Reprinted with permission.

oping typically (Paul, 1989a, 1989b). It is not surprising that higher interpretative skills, such as those used to comprehend humor, are often not observed in children with severe LI. Even mature language users rely on world knowledge to some extent (Milosky, 1990). Comprehension consists of both decoding the syntactic and semantic information and interpreting that information based on the linguistic and nonlinguistic context and world knowledge. While comprehension intervention is a worthy goal in and of itself, I should caution that training word recognition alone does not ensure production of newly learned words (Kiernan & Gray, 1998). The goal of intervention is to teach the child to retrieve relevant word and world knowledge as a comprehension aid and to help the child decide how and what to remember from what he or she hears or reads (Trabasso & Van Den Broek, 1985). Comprehension and memory are aided by familiar, meaningful contexts; thus, intervention should occur within familiar routines and locations (Milosky, 1990). The degree and type of experience the child has with events strongly shapes his or her expectations and, thus, comprehension. Meaningful activities are more comprehensible; they make more sense. Familiar play and role-play of everyday events can enhance comprehension. The level of involvement also affects memory and comprehension (Lehnert & Vine, 1987; Miall, 1989). The more involved a child is, the more he or she comprehends and recalls. Songs, nursery rhymes,

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and finger play can be used to help a child make active associations between words and the nonlinguistic context (Paul, 1990). The repetitive nature and limited focus of such activities help shape expectations and aid comprehension and memory. In “Where Is Thumbkin?” the structure is where . . . here with the phrases repeated several times. Similarly,“Farmer-in-the-Dell” uses an agent + action + object format in each verse (The farmer picks a wife . . . ) (Paul, 1990). These repetitions aid comprehension. Finally, comprehension intervention should be pleasurable. Fun activities keep children engaged, a necessity for comprehension and comprehension training. Involvement is fostered by facilitator feedback. A pleasing manner encourages responding and making use of the feedback (Paul, 1990). Initial comprehension training may need to be very concrete and highly contextual. Preschool children benefit more from direct labeling instruction than from less direct use of narratives (Kouri, 1994). The use of gestures and a slower rate of talking by the language facilitator also enhances comprehension by young children (Weismer & Hesketh, 1993). Likewise, slower rate improves the receptive language processing of children with SLI (Montgomery, 2005). As children approach school age, training should become more decontextualized, similar to many of the literate activities found in school. Comprehension training might begin with recall from pictures or objects and progress to literal recall of one or more details from verbal sources. Gradually, an SLP can require a child to recall more details. Later, the child can detail these in sequence, possibly using sequential pictures, photographs of past events, or comic books as aids. Daily events can provide a script to aid comprehension. Next, the SLP can require the child to relate cause and effect from familiar or recently read narratives. Once able to reconstruct these relationships, the child can begin to make inferences, to draw conclusions, and to predict outcomes from stories, riddles, and jokes. Finally, the child can learn to synthesize information and create subjective summaries of the meanings of narratives, TV shows, or movies. To assist comprehension, the SLP can shape question-response strategies by manipulating the semantic content, complexity, context, and function (Parnell & Amerman, 1983). The therapy process moves from simple, context-embedded questions to the use of questions in more abstract contexts, while controlling the length of the questions to highlight semantic content (Moeller et al., 1986). For example, in the first stage, the facilitator might attempt to build awareness and enhance emerging skills by using topics of high interest as the question contexts. The facilitator concentrates on establishing repeatable responses to yes/no questions by using a second adult as a model, multiple-choice alternatives (“Did the ball roll under the sofa? Yes or no?”), visual cues to signal that a response is desired, and the child’s natural, everyday contexts. In the second stage, early-developing wh- question forms might become the targets, and yes/no questions be used to highlight the semantic content desired. Take, for example, the question, “What is the girl wearing on her head?” A nonresponse, an inappropriate response, or an inaccurate response might be followed by “Is she wearing a shoe on her head?” If the child responds negatively, the prompt would be “That’s right, what is she wearing on her head?” Print, pictures, or signs can be used to highlight the wh- words and, thus, emphasize the information desired. These prompts can be faded gradually. In the third stage, new wh- forms are added systematically. Developmental data suggests a logical order for teaching wh- words and question types based on concept learning. Initial wh- words concern things (objects), persons (agents), possession, and locations, all early expressions in children’s utterances. These include the wh- words what, who, whose, and where respectively. Soon children learn distinctions between things, as expressed in the word which. Around age 4, they become aware of sequence, time, and causality, or the wh- words and questions how, when, and why respectively. In the final stage,

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stimulus content is shifted gradually from concrete, predictable, factually based academic topics to more abstract, less predictable conversational ones. School-age children might manipulate objects or pictures and match them with the sentences heard (Wallach & Miller, 1988). For example, the child might be told to place a small red ball on top of a large yellow box. Similarly, the child might select a picture described by the facilitator from among a set of pictures. Written cues also could be used. The child also might match sentences with similar meaning. Synonyms can be introduced. Metalinguistic skills can be enhanced by tasks in which the child judges similarity and difference among sentences (van Kleeck, 1984). This task may be difficult for those with poor working memory. Figurative Language Figurative language consists of idioms, metaphors, similes, and proverbs. Idioms are a form of figurative language that is particularly troublesome to comprehend for school-age children with LI and for children from CLD backgrounds (Lutzer, 1988; Seidenberg & Bernstein, 1986). The most common error is literal interpretation. Although idioms are a concise, colorful, and intriguing way to express complex meanings, they are very diverse and, thus, difficult to learn as a group. Idioms vary along several continuums, including single-words-to-clauses, colloquial-to-formal, and concrete-to-abstract. Difficulty with idioms can affect classroom comprehension because of their frequent occurrence (Nippold, 1991). Approximately 11.5 percent of teacher utterances contain at least one idiom, with a range from 4.7 percent in kindergarten to 20.3 percent in eighth grade (Lazar et al., 1989). Similarly, 6.7 percent of the sentences in textbooks contain idioms, with a range from 6 percent in third grade to 9.7 percent in eighth (Nippold, 1990). The meanings of idioms are inferred gradually from repeated exposure in context. In addition, idiom learning requires metalinguistic skills and is closely associated with familiarity with the idiom and skills in reading and listening comprehension (Nippold, Moran, & Schwarz, 2001). Children with LI may lack a strategy for determining meaning. Some common high- and low-familiarity idioms are listed in Table 11.12. Intervention should begin with comprehension of transparent or easily decipherable idioms. Narratives may be the best teaching milieu because of the contextual support (Nippold, 1991). The child can be instructed prior to the narrative that it will contain a certain idiom and that he or she will be able to figure out the meaning from the story. Questions can be used throughout the narrative to help the child attend to important information. Answers can be redirected to ensure that the child is attending to salient points. After repeated exposure and the child’s correct interpretation, he or she can be encouraged to invent his or her own narratives that illustrate use of the idiom. Finally, conversationally appropriate use can be discussed and role-played. Proverbs depend on their context to be good advice. Sometimes he who hesitates is lost, but at other times, it’s best to look before you leap. The context in which the proverb is used also facilitates understanding. In general, concrete proverbs are easier to interpret than abstract, and familiar easier than unfamiliar (Nippold & Haq, 1996). The ability to explain proverbs lags behind the ability to select an appropriate interpretation from a list of possible meanings (Nippold, 2000). Obviously, an explanation reapires more linguistic skill. The ability to interpret and use proverbs develops during late elementary school and continues into adulthood and is related to reading and metalinguistic abilities. With this in mind, an SLP is advised to teach proverb interpretation within the context of reading (Nippold, 2000). Working in

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TABLE 11.12

Common American English Idioms

Animals

A bull in a china shop As stubborn as a mule Going to the dogs Playing possum Go into one’s shell

A fly in the ointment Clinging like a leech Grinning like a Cheshire cat Thrown to the wolves

Body Parts

On the tip of my tongue Raise eyebrows Turn the other cheek Put their heads together* Vote with one’s feet

Breathe down one’s neck* Put your best foot forward Turn heads Put one’s foot down* Lead with one’s chin

Clothing

Dressed to kill Hot under the collar Wear the pants in the family

Fit like a glove Strait-laced Talk through one’s hat

Colors

Grey area Once in a blue moon Tickled pink

Has a yellow streak Red letter day True blue

Foods

Eat crow Humble pie That takes the cake

A finger in every pie In a jam Put all your eggs in one basket

Games and Sports

Ace up my sleeve Cards are stacked against me Got lost in the shuffle Keep your head above water Paddle your own canoe Rise to the bait Skate on thin ice*

Ballpark figure Get to first base Keep the ball rolling On the rebound Go around in circles* Cross swords

Plants

Heard it through the grapevine Resting on his laurels Beat around the bush* No bed of roses

Shaking like a leaf Withered on the vine Hoe one’s own row

Vehicles

Fix your wagon Like ships passing in the night On the wagon

Don’t rock the boat Missed the boat Take a back seat

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Common American English Idioms (cont’d)

Tools, Work, and School

Bury the hatchet Has an axe to grind Hit the nail on the head Jockey for position Throw a monkey wrench into it Read between the lines*

Doctor the books Has a screw loose Hit the roof Nursing his wounds Sober as a judge

Weather

Calm before the storm Haven’t the foggiest Steal her thunder

Come rain or shine Right as rain Throw caution to the wind

*Highly familiar Source: Compiled from Clark (1990); Gibbs (1987); Gulland & Hinds-Howell (1986); Nippold & Rudzinski (1993).

small groups, adolescents can discuss interpretations. The SLP uses structured modeling and practice strategies, such as the use of contextual cues, questions, and analysis, to help teens become independent learners. Through both asking and answering factual and inferential questions, adolescents learn to interpret the context. Analysis of the main characters’ motivations, goals, actions, and feelings further aid interpretation. Finally, adolescents need help determining the relationship between the proverb and their own lives. Microcomputers can be used to teach figurative language comprehension. Computers have special advantages, including inherent motivation, active involvement, nonjudgmental feedback, and an independent, self-paced mode of operation (Fitch, 1986; Sanders, 1986). Verbal Working Memory Although the depth and breadth of this topic is beyond the scope of this text and the topic fits only loosely—if at all—under semantics and comprehension, I would be remiss were I not to mention verbal working memory given the deficits mentioned in Chapter 2, especially for children with SLI. Verbal working memory can be strengthened in several ways. For example, an SLP can help children focus on a task by explaining its purpose, importance, and what it will accomplish (Ylvisaker & DeBonis, 2000). The SLP will need to slow the rate of presentation and decrease the size of processing units. These can both be increased gradually as training progresses. The SLP can use verbal repetition tasks in which the number of syllables and words are gradually increased. Unrelated words are theoretically more difficult than words in a sentence, the more typical conversational processing task. For the child who is not attending or is distracted, however, syntactic cues may be missed or go unused. In any listening task, including conversational and classroom use, a child will need to bring past knowledge to bear. The SLP can help the child build a knowledge base by using tasks that are familiar to the child and/or revolve around a theme. The child and SLP can discuss key words and relationships prior to beginning. Through explanation of the importance of syntactic cues and the use of cloze procedures, an SLP can help a child attend to these features. In the cloze, or fill-in-the-blank, procedure, the child must

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process the sentence in real time (as it’s heard) to be able to complete it. Verbal absurdities can also be used and the child asked to explain them. The SLP must be careful not to exceed the processing capabilities or the language abilities of the child. Memory and direction-following games can be great fun here. The use of linguistic cues of many types—such as phonemic, syntactic, semantic, and pragmatic— can be integrated and explained. Through the use of successively longer sentences, the SLP can manipulate cues to aid in the interpretation of cloze sentences. For example, the SLP might present a short sentence such as “We eat _____.” Children working in small groups brainstorm possible words to finish the sentence. In like fashion, the SLP presents alternative choices, and the children discuss why these are acceptable or not based on the information given. Obviously, in this example, several words are acceptable. After completing the discussion, the SLP presents the same sentence or a very similar one with more information, such as “We eat at _____,” and the exercise continues. The importance of verbal working memory is very evident, especially as the sentences become longer. Processing within actual use contexts is the goal of intervention. Each session should provide real conversational activities within which the SLP can monitor each child’s behavior and aid participation.

Syntax and Morphology Although language use improves syntax, the reverse is not true. It is important, therefore, that syntactic training be as conversational as possible. When language forms or constructions are taught outside a communication context, the forms may be mastered without the knowledge of how to express ideas within and across these forms (J. Norris & Bruning, 1988). In addition, utterances produced in a context such as conversation strengthen cohesion and relationships across linguistic units. The linguistic techniques discussed in Chapter 10 are particularly applicable to syntactic and morphologic training. Methods requiring an imitative or spontaneous response by the child are reported to be superior to those presenting only a model, although focused stimulation can be very effective (Connell & Stone, 1992). Feedback is also very important. During training, it is important that the facilitator control for vocabulary and/or sentence length, especially when teaching new structures. If the facilitator changes too many variables at one time, it may confuse a child or make the task too complex for successful completion. The facilitator also should be careful not to require metalinguistic skills beyond a child’s abilities. Although recognition and comprehension usually precede production, judgments of correct usage do not. Judging a sentence to be grammatically correct is a metalinguistic skill that develops in the middle elementary school years. Asking children to form sentences with selected words (coat john a yesterday new bought) also requires metalinguistic skill. In short, any task that requires the child to manipulate language abstractly takes some degree of metalinguistic skill. The development of syntactic and morphologic forms is well documented and provides a guide for intervention. In the following section, hierarchies for intervention with several different forms are discussed. The purpose is to offer general guidelines for the ordering of structures to be taught. Just as development is a gradual process, especially for older children and adolescents, so too is intervention. It may be unrealistic to expect error-free production following teaching (Nippold, 1993). Some low-frequency forms are difficult even for adults.

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MOR PHOLOGY Inflectional suffixes develop early and lend themselves well to teaching within a conversational milieu. Other morphemes may best be taught in a more explicit manner first, beginning with derivational suffixes, followed by prefixes (Rubin, 1988). Explicit training is not recommended for preschool children. The unique learning style of children with SLI also may make explicit rule learning less effective (Swisher, Restrepo, Plante, & Lowell, 1995). Common bound morphemes are listed in Appendix C. Because derivational relationships are complex and irregular, memorization is of little value as a learning tool (Adams, 1990). It is essential that the child understand the changes in meaning that are occurring. Although data for school-age morphological development are scarce, some suggestions for the method of teaching do exist. These are presented in Table 11.13. Training should begin with the most transparent and most common morphemes and proceed toward those that are more complex and cause phonological and orthographic or spelling changes. The school-age child should be taught to analyze from derived words to word stems and to synthesize from word stems to derived words (Moats & Smith, 1992). Meaning relationships should be emphasized. The metalinguistic skill of awareness of word structure is essential to the analysis of complex structures. These skills should be taught and used at all levels from word imitation to conversational use. Young school-age children who read and have some metalinguistic skills can be taught to differentiate word structures (Rubin, 1988; Rubin, Patterson, & Kantor, 1991). Words can be contrasted on the basis of structure and rhyming, as in money-funny, wise-pies, and pinned-wind, or on small structural changes that affect meaning, as in winner-winter. Middle-school children can be taught complex derivational morphology (Moats & Smith, 1992). Training can occur in both the oral and written modes. Training for middle-school children also should include Latin and Greek roots because of the frequency of these in science, math, and social studies (Henry, 1990). VE R B TE NSI NG Although a typical 2-year-old has a notion of action words, the child does not understand the many forms these verbs can take; nor does the child comprehend other verbs that express notions such as state. Verb learning takes several years, with the rules being mastered slowly. Verbs are very difficult for children with LI, partly because of the many ways they are treated syntactically and morphologically. Studies with TD preschoolers suggest that verb learning is enhanced when specific movements are associated with different verbs (Brackenbury & Fey, 2003). The teaching of verb tensing can be adapted easily to everyday activities in which children discuss what they are doing at present, did previously, or will do in the future. Art projects and building toys such as Legos are especially useful. Appendix E offers a number of activities for targeting verb tensing. Training should begin with protoverbs, such as up, in, off, down, no, there, bye-bye, and night-night. These verblike words usually are used in relation to some familiar action sequence. General purpose verbs, such as do, might be targeted next. More specific action verbs should be introduced in their uninflected or unmarked form. The facilitator can cue by asking what a child is doing or by directing the child, “Tell X to (verb).” To facilitate learning, action word meanings might be taught with specific actions or objects. Children first describe their own actions, not those of others. While playing, the facilitator can hide his or her eyes or turn

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TABLE 11.13

Suggested Order for Teaching Morphemes

1. Establish awareness of syllables and sounds. Practice counting both. 2. Identify roots and affixes. Practice pronouncing and defining roots and affixes in contrasting words that are similar in sound or appearance, such as happy-sunny, and include-conclude. 3. Generate a formal definition in the form “A/An X is a (superordinate category) that (restrictive attributes).” 4. Discuss relationships with other words. 5. Use words in meaningful contexts and in analogies and cloze activities. 6. Use words in reading activities if appropriate. 7. Introduce spelling and spelling rules if appropriate. Source: Adapted from Moats & Smith (1992).

away from the child and ask, “What are you doing?” Although the cue requires an -ing ending on the verb in the response (“Eating”), this form is not required of the child at this level of training. I usually simplify my question to “What do?” The response is “Eat” or “Eat cookie.” Familiar event sequences, such as play or routines, facilitate action verb usage because of the mental representations of these sequences that children possess (K. Chapman & Terrell, 1988). These event sequences enable the child to focus on the communication, rather than on the extralinguistic elements of the event (Constable, 1986). In verb learning, children with SLI benefit from multiple and well-spaced presentation of labels (Riches, Tomasello, & Conti-Ramsden, 2005). Massed training in which several words are presented in a single session requires a greater number of presentations of each word before learning occurs. Once a child is able to form simple two- and three-word utterances with an action word, as in “Doggie eat meat,” the present progressive verb form can be introduced without the auxiliary verb. The SLP can model this form through self-talk and parallel talk. The SLP can cue the child to use this form with “What’s doggie doing?” or “What’s he doing?” Pronouns, such as he, must be used with caution at this level because many children with LI use very few. At this level of training, a child only needs to deal with the immediate context. A sense of time beyond the present, however, is essential for further verb training. The SLP can use a few high-usage irregular past tense verbs, such as ate, drank, ran, fell, sat, came, and went, to introduce the past rather quickly and to forestall overgeneralization of the regular past -ed, the next target form. With both past tense forms, storytelling, show-and-tell, and recounting past events are good vehicles for training and use. Initially, the facilitator can ask the child a question like “What did you eat (or other action verb)?” to teach the child the form. When the child responds with “Cookie” or another entity, the facilitator can reply,“What did you do with cookie?” Later, the sequence can begin with the question, “What did you do?” The child responds, “Ate cookie,” or, “I ate a cookie.” It is important that question cues not violate pragmatic contingency, which requires that questions make sense. When possible, facilitators should not ask questions to which they know the answers. This strategy is achieved easily by asking about unobserved actions or having a puppet ask questions. Before training additional verb forms, the SLP should introduce singular and plural nouns and subjective pronouns because the child will need these for the third-person singular present tense -s marker and for present tense forms of the verb to be.

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The SLP can introduce the third-person marker with singular nouns. Subjective pronouns can be introduced gradually. He or she can elicit the third person marker with such cues as “What does he do every day (all of the time)?” or such fill-ins as “Every day, the girls (verb),” or “All of the time, he (verbs).” Targeting of third-person -s or the auxiliary verbs is/are/was in a focused stimulation story followed by a play period in which the SLP recasts the child’s sentences containing the target result in significant gains in target learning (Leonard, Camarata, Brown, & Camarata, 2004; Leonard, Camarata, Pawlowska, Brown, & Camarata, 2006). In a variation, the SLP acts out the story with toys as she tells it. Children demonstrate learning of nontargeted forms that also demonstrate verb-tense and noun–verb agreement. In other words, learning of the third-person -s marker generalizes to is/are/was, and vice versa. The SLP should not target the phonological variations of the -ed marker (/d/, /t/, and /Id/) and those of the third-person -s (/s/, /z/, and /Iz/) in initial training. When the marker is first being emphasized in training, the SLP should use one form exclusively, such as the /d/ or the /s/. As the emphasis on the marker becomes more natural or lessens, its cognate can be introduced without any fanfare. Be careful: It’s not the “d” or “s” sound, but /d/ and /s/. Facilitators should not expect a child to understand the phonological rules relative to ending sounds and added markers. Usually, deemphasis of the marker’s sound will allow the child to produce naturally either two voiced or two unvoiced sounds at the end of each word. The /Id/ and /Iz/ markers should be avoided until later. Children developing typically usually employ the cognates by late preschool. It takes them a few more years to acquire the /Id/ and /Iz/ forms. You may recall from your language development course that one of Slobin’s (1978) languagelearning principles of children is “Grammatical markers should make semantic sense.” This can be helpful in teaching language as well. For example, it’s easier for children with LI and those developing typically to use the past-tense -ed on verbs of short duration and a definite end, such as drop (Leonard, Deevy, Kurtz, Krantz Chorev, Owen, et al., 2007). Other verbs with less distinct end points, such as play, are more difficult. Lists of both types of verbs are presented in Table 11.14.

TABLE 11.14

Easy and Difficult Words to use with Past-Tense -ed

Actions with a Definite End

Close Cover Drop Dump Jump over Kick Knock Open Pop Scare

Actions of Longer Duration

Brush Carry Chase Crawl Dance Hop Play Pull Push Rake

Source: Adapted from Leonard, L. B., Deevy, P., Kurtz, R., Krantz Chorev, L., Owen, A., Polite, E., Elam, D., & Finneran, D. (2007).

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Use of pronouns enables the child to begin training on the contracting forms of the verb to be both as an auxiliary verb and as the copula or main verb. This does not preclude earlier targetting of is, the most common form, with singular nouns. Because the form is noun (or pronoun) + be + X, in which the X can be a noun, adjective, adverb, or verb with -ing, these two forms can be trained together, thus facilitating carryover. The distinction between auxiliaries and main verbs is too complex to try to explain here. As a rule, the uncontractible form is taught first, the uncontracted contractible next, and the contracted contractible form last. The verb to be is a “regularist’s” nightmare, with different forms for various persons and tenses. Therefore, different forms should be introduced slowly. Children developing typically generally learn the is form first. Other auxiliary verbs, such as do, also can be introduced to facilitate the development of more mature negatives and interrogatives. The negative form of do can be elicited with “Tell X (some person) not to verb.” Do, can, and will/would appear first in the negative form in the language development of children developing typically. In other words, can’t, don’t, and won’t appear before can, do, and will/would. Using the present progressive form be + going, the child can begin to form early future tense forms. Facilitators should be willing to accept this form because it marks the concept (Bliss, 1987). Training should begin with going to noun, as in “going to the zoo,” before going to verb, as in “going to eat.” The former is more concrete and does not require use of an infinitive phrase, such as to eat. The more mature will form of the future tense can be introduced later. Guidelines for training can, do, and will/would include the following (Bliss, 1987): 1. Allow some delay between mastery of one form and introduction of another in order to avoid confusion. 2. Use self-reference in the form of either first-person pronouns or the child’s name initially because this is the first referent associated with these forms. 3. Link these forms with actions because this is the first association of children developing normally. 4. Initially, use short utterances with the word at the end in order to increase saliency (“Can you jump?” “Yes, I can.”). Use the popular Bob the Builder refrain “Can we do it?” “Yes, we can.” 5. Provide meaningful situations in which the concepts and forms serve some purpose. An explanation of guideline 4 is in order. Children with SLI have particular difficulty with verbs, verb endings, tenses, and verb phrases (Hadley, 1998a). These children are more likely to use an auxiliary verb if it is included in the preceding sentence, but both the form and location must be considered (Leonard, Miller, Deevy, Rauf, Gerber, et al., 2002). Although the exact form of the verb does not need to be in the preceding sentence, some forms do facilitate others. For example, use of are facilitates is. The sentence-final position (Yes, we can) also facilitates learning, but the sentence-initial position as in questions (Can we do it?) does not (Fey & Frome Loeb, 2002). With the addition of the future tense, a child now can discuss the past, present (progressive), and future. Language activities can now include planning, execution, and review. After teaching other auxiliary verbs, the SLP can introduce modal auxiliaries. These are helping verbs that express mood or feeling, such as could, would, should, might, and may. The shades of meaning across the various modal auxiliaries are often very subtle, and the facilitator should not expect mature usage for some time. Most adults have difficulty with the distinction between may and might.

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Finally, the SLP may wish to target verb particles, multiword units, such as pick up and come over, that function as verbs. Although verb particles emerge in early preschool years, they are not fully acquired and differentiated from prepositions until age 5 (Goodluck, 1986; Tomasello, 1987; Wagner & Rice, 1988). The particle—up, down, in, on, off—may either precede or follow a noun phrase, as in kick over the pumpkin or kick the pumpkin over, or follow pronominal phrases, as in kick it over. Prepositions, in contrast, always precede noun phrases, even those with pronouns, as in over the box or over it. The acquisition of verb particles is especially difficult for children with LI, possibly because they are unstressed units and may appear in either position vis-à-vis the noun phrase (Watkins & Rice, 1991). Particles should be introduced with a limited set of verbs used regularly by the child. It might be helpful to use position cues to teach the distinction between particles and prepositions. Particles could be taught following the noun phrase and prepositions preceding. Particles preceding the noun phrase could be introduced later. Procedures for teaching verb tensing should make sense both semantically and pragmatically (Bliss, 1987). Examples are asking the child to perform various tasks (“Will you please . . . ?”), problem solving (“What will happen if . . . ?” “What might happen if . . . ?”), and role-playing (“What should we do if . . . ?”). Many children’s books—discussed in the next chapter—lend themselves to predicting tasks. PRONOU NS Pronouns are extremely difficult to learn because the user must have syntactic, semantic, and pragmatic knowledge. In general, an SLP should teach the underlying concept first and should model appropriate use for the child. Use of pronouns requires an understanding of the semantic distinctions of number, person, and case. The noun in the sentence generally determines use, but the conversational context is also a determinant. Several parent and teacher practices that make language easier for the child to process may, however, confuse pronoun learning and use. Overuse of nouns or of the royal we (e.g., “We are tired” to mean that the speaker is tired) model inappropriate use. Children often avoid making an overt pronominal error by overusing nouns. This mistake can be avoided somewhat in training by limiting the number of referents. For example, if the SLP uses too many characters in a story format, the child may overuse nouns in an attempt to remember who is being discussed. Using nouns can help children whose memory is somewhat limited. In general, the first person I should be trained before the second person you, followed by the thirdperson he/she. This developmental order reflects increasing complexity with shifting reference and the number of possible referents. Deictic terms, such as I and you, are difficult to teach. A second SLP, facilitator, or child can serve as a model to avoid confusing the child’s frame of reference. Development by typical children would suggest that facilitators target subjective pronouns (I, you, he, she, it, we, you, they) before objective pronouns (me, you, him, her, it, us, you, them). Possessive pronouns would follow (my, your, his, her, its, our, your, their), and, finally, reflexive pronouns (myself, yourself, himself, herself, itself, ourselves, yourselves, themselves). Although there are exceptions to this hierarchy, it approximates typical development (Haas & Owens, 1985). Subjective and objective case can be taught by location in the sentence.

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This hierarchy and the error patterns of young children suggest that reflexives might be trained initially as possessives (my self). The exceptions (himself and themselves) can be introduced later. One exception to the suggested hierarchy might be third-person singular pronouns. It appears easier for children to learn her-hers-herself than him-his-himself, probably because of the consistency in the feminine gender (Haas & Owens, 1985). The three feminine pronouns might be trained as a unit before the masculine. Conversational training with so many varied forms can be very confusing. Initially, the facilitator must target carefully the desired pronouns and practice cues to elicit these forms. Pronouns can be taught in any context where an object, toy, doll, action figure, character, or the child does something repeatedly, as in play or a narrative. After something or someone has been introduced, we use pronouns on repeat mention. For example, while telling a story from a book, a child might point and say,“He’s Xing,” or “They want X.” While directing play, a child may say,“You be the boy and I be the girl. And this bes your fairy. He jump and he follow you everywhere. Now you both go sleep.” When pronouns are not used, they can be prompted or modeled for the child. For example, if the child said, “And this bes your fairy. Fairy jump and fairy follow you everywhere,” the SLP might reply, “He does. He jumps and he follows me everywhere. What else?” PLU RALS To learn plurals, the child must have the concepts of one and more than one. Numbers or words such as many and more may serve as initial aids. Begin with comparisions of one item versus many. Cue with “Show me (Touch) more,” then respond, “Yes, more blocks!” As with the past-tense -ed and third-person -s markers, the facilitator should not expect mastery of the phonological rules until later. Again, training should begin with either the /s/ or the /z/, gradually introduce the other, and wait some time before introducing /Iz/. The SLP may wish to introduce a few common irregular plurals to forestall overgeneralization. As mentioned in the Semantics section of this chapter, words such as water and sand are not irregular plurals and present a special case, especially with the modifiers any and much. Because so many toys have parts, play is almost a natural for teaching plurals. Use a key word such as many or more to signal the child to use the plural marker. Teaching of plurals also lends itself nicely to a top-down approach. Review the verbal responses at the end of Chapter 10. Once a child is responding correctly with many or more, expand into more quantity words or counting. Use replica play of a birthday party or grocery shopping to elicit plurals. At birthday parties, there can be balloons, favors, treats, cookies, presents, cards, and games. ARTICLES Articles are extremely difficult for children to learn because of the two different operations they perform. Articles may mark definite (the) and indefinite (a) reference and also new (a) and old (the) information. When in doubt, preschool and early elementary school children tend to overuse the. Articles and adjectives are acquired gradually along with development of the noun phrase (Kemp, Lieven, & Tomasello, 2005). Pragmatic reference (new/old) may be more difficult than the definite/indefinite distinction. Although few 2-year-olds use articles, 3- through 6-year-olds tend to use both articles and adjectives with specific words, suggesting that individual words may influence use. For example, a child may use the white kittie but not the white snow.

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An SLP can use objects and pictures in play or books and instruct the child to describe what is seen (“A puppy”). Next, the SLP and the child can describe each object or picture, as in the following exchange: Facilitator: Tell me what you see. Child: A duck. Facilitator: A duck? Let’s see. I can tell you that the duck is yellow. What can you tell me? Child: The duck is swimming. The article an should not be introduced until a child is functioning at the early elementary school level. Once pronouns have been introduced, the facilitator can switch back and forth between pronouns and articles, as in the following: Facilitator: Here’s a puppy. What can you tell me about him? Child: He has a cold nose. Facilitator: Who does? Child: The puppy. The possibilities are endless within a conversational paradigm. Remember that many Asian languages don’t have articles, so this feature may be especially difficult for some Asian children with LEP. PR E POSITIONS Although nine prepositions (at, by, for, from, in, of, on, to, and with) account for 90 percent of preposition use, these nine have a combined total of approximately 250 meanings. No wonder some children with LI have difficulty with this class of words. Children with LEP will find prepositions especially difficult. Prepositions are discussed briefly in the Semantics section under relational terms. Development of prepositions suggests the following hierarchy of training: in, on, inside, out of under, next to between, around, beside, in front of in back of, behind Such terms as in front of and behind should be trained initially by using fronted objects, for example, a television. Nonfronted objects can be introduced later. In general, children will learn more easily when real objects are used in training. Actual manipulation of these objects, however, may interfere with learning. Such experience may be better at the level of conceptual rather than linguistic training. Spatial and directional aspects should be trained with a number of objects and/or examples so that a child understands the concept separately from any specific referent. Variety may preclude the child’s focusing on the objects and referents in favor of the relationship. Large muscle activities also can be used as children go in and out of boxes or closets, on and off tables and chairs, and the like. Thus, the child’s body becomes a referent (Messick, 1988). Spatial terms may be taught in a naturalistic context of play with puppets, dolls, action figures, or the child’s

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body. In one lesson, I played the tiger who pursued a preschool child in the cage, out of the cage, and so on. WOR D OR DE R AN D SE NTE NCE TYPES Word order and different sentence types are best trained within conversational give-and-take, although school-age children and adolescents also may benefit from both oral and written training (Nippold, 1993). Miniature linguistic systems have been used to teach word combinations (Bunce, Ruder, & Ruder, 1985). In these systems, a matrix is developed with one class of words on the ordinate and another on the abscissa. A child need not learn all possible combinations to acquire the rule. Good generalization to untrained combinations has been reported. Figure 11.4 presents some sample matrices and the teaching models that have been effective. Noun phrases initially can be expanded in isolation. A question-answer paradigm will enable an SLP to target specific aspects of the noun phrase (How many . . . , Where . . . , Can you describe . . . ?). Once placed within short sentences, the noun phrase can be expanded in the object position, followed by the subject position. Early expansion rarely goes beyond two elements, as in a kitty or big horse. The order of noun modifiers is discussed in Chapter 7 under analysis of the noun phrase (Table 7.17). It’s worth recalling from the discussion of articles that TD 3- through 6-year-olds tend to use both articles and adjectives with specific words, suggesting that individual words may influence use. To me this means three things: is gradual and intervention should be also. • Acquisition Contrastive training makes sense, e.g., the white kittie, the brown doggie. • Generalization won’t just happen; it must be planned for. •

Eat Bake Mix Want Give

Feed Bathe Groom Walk Brush

Cookie

Cake

Pudding

Pie

Bread

X X X X X

X

X

X

X

Pet

Dog

Cat

Horse

Ferret

X

X X

X X

X

X X

X X

Verbs on one axis are combined with nouns on the other to form short phrases. Each combination taught is marked with an X. Rule learning will generalize to the untrained combinations.

FIGURE 11.4

Miniature linguistic systems.

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Adjectives can be taught in contrastive situations in which the child must distinguish between two objects that differ along one parameter, as in big ball and little ball (Kamhi & Nelson, 1988). Incorrect or inadequate adjective use in conversation would result in misunderstanding and the misinterpretation of the child’s message. In a similar fashion, post-noun modifiers can be used with objects in different locations, as in the ball in the box and the ball on the table. Verb phrases and accompanying clause types should be chosen carefully. Specific verbs that clearly illustrate transitive and intransitive clauses might be chosen. Equitive verb phrases and the use of be can be trained in elliptical answers to questions, as in He is and We are responses to questions such as “Who is at the zoo?” The uncontractable form of the verb is very salient in this format, as in he is or they are. A similar method of teaching transitive and intransitive verbs can be used to teach auxiliary verbs, as in “Who is eating?” and “Who can jump?” (Kamhi & Nelson, 1988). Infinitive phrases can be taught within play situations with dolls, puppets, or action figures or within storybook reading (Eisenberg, 2005). Of the two types of infinitives, noun–verb–to-verb (Oscar wants to eat) and noun–verb–noun–to-verb (Oscar wants Ernie to eat), the former is easier to learn and develops first. Early-developing and frequently used verbs that take an infinitive complement in the N–V–to-V form include want, like, and try. A possible format for training is presented in Table 11.15. Using both oral and written techniques, the SLP can aid later-school-age children and adolescents to form longer sentences and more concise sentences and to use more low-frequency structures and intersentential cohesion (Nippold, 1993). Compound and complex sentences can be formed from a child’s own simpler sentences. Subordinate clauses, such as who is driving the red car, can be transformed later into more concise phrases, such as The girl driving the red car is from Iowa. Lowfrequency structures, such as apposition (Mary my sister . . . or John the psychologist will . . . ), complex noun phrases (the large red dog with the bushy tail or teachers such as Ms. Meeker or Ms. Lilius), perfect aspect (has been verbing), and passive voice (The cat was chased by the dog). Finally, intersentential cohesion can be attempted by using adverbial conjuncts such as therefore and however. Acquisition is often very gradual. Less common types, such as conversely and moreover, should be introduced to mature language users. Several strategies discussed in Chapter 10 can be used very effectively to strengthen word order. For example, expansion can provide a more mature model than a child’s utterance, and buildup/breakdown strategies help the child analyze relationships. Table 7.16 presents some guidelines on the acquisitional order of certain sentence types. By the time most TD children begin school, they are using adultlike declaratives, imperatives, and wh- and yes/no interrogatives in both the positive and negative forms. Later developing forms include clausal and multiple embedding and conjoining, passive voice, and tag questions. SU M MARY Although an SLP cannot always use all elements of the functional model simultaneously, he or she usually can use several elements within any given teaching situation. The target selection certainly should reflect a child’s overall communication needs. Facilitators within the environment, everyday activities, and conversational give-and-take usually can be adapted to the individual child and language target(s). Some training may necessitate the initial use of structured approaches. Generalization to conversational use, however, will require incorporating everyday settings and activities into the training.

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TABLE 11.15 Target Response

N–V–to-V Want to

Like to

Try to

Possible Intervention with Infinitives

Adult Cues

Suggested Adult Prompts (increasing adult input)

Nonverbal: Playing house. Ernie stumbles around. Verbal: Ernie says to Elmo, “I’m very tired. Can I Ernie wants . . . sit?” You finish the story. Ernie wants . . . ? Ernie wants to . . . Does Ernie want to eat? No. What does Ernie want? Ernie doesn’t want to eat. Ernie wants . . . ? Ernie doesn’t want to eat. Ernie wants to . . . ? Ernie wants to sit. What does Ernie want? Nonverbal: Playing with tools. Elmo wants the hammer.* Verbal: Elmo says to Oscar, “I will hammer. That Elmo likes . . . is my favorite thing to do. Elmo likes . . . ? Elmo likes to . . . Does Elmo like to saw? No. What does Elmo like? Elmo doesn’t like to saw. Elmo likes . . . ? Elmo doesn’t like to saw. Elmo likes to . . . ? Elmo likes to hammer. What does Elmo like? Nonverbal: Playing eating. Cookie Monster wants to jump over the table. Verbal: Cookie Monster says, “I will jump over Cookie tries . . . the table.” Cookie tries . . . ? Cookie tries to . . . Does Cookie try to run? No. What does Cookie try? Cookie doesn’t try to run. Cookie tries . . . ? Cookie doesn’t try to run. Cookie tries to . . . ? Cookie tries to jump. What does Cookie try? (Continued)

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(Continued) Possible Intervention with Infinitives

Adult Cues

N–V–N–to-V Want N to Nonverbal: Play eating. Elmo won’t eat. Verbal: Ernie says to Elmo, “Eat your food.” You finish the story. Ernie wants Elmo . . . ?

Tell N to

Specific Intervention Techniques

Nonverbal: Ernie is frightened by a big dog. Verbal: Bert says to Ernie, “Let’s run!” You finish the story. Bert tells Ernie . . . ?

Suggested Adult Prompts (increasing adult input)

Ernie wants Elmo . . . ? Ernie wants Elmo to. . . ? Does Ernie want Elmo to jump? No. What does Ernie want? Ernie doesn’t want Elmo to jump. Ernie wants Elmo . . . ? Ernie doesn’t want Elmo to jump. Ernie wants Elmo to . . . ? Ernie wants Elmo to eat. What does Ernie want?

Bert tells Ernie . . . ? Bert tells Ernie to . . . ? Does Bert tell Ernie to sleep? No. What does Bert tell Ernie? Bert doesn’t tell Ernie to sleep. Bert tells Ernie . . . ? Bert doesn’t tell Ernie to sleep. Bert tells Ernie to . . . ? Bert tells Ernie to eat. What does Bert tell Ernie? Bert tells Ernie to run. What does Bert tell Ernie?

*Choose entity names that can also be verbs. Source: Adapted from Eisenberg, S. (2005).

Children with CLD Backgrounds Schools are among the most multicultural institutions in U.S. society. Immigrants are increasingly poor and older than in the recent past. These children are less successful in school than their monolingual classmates speaking English and are more likely to become dropouts. In general, these children are overrepresented in programs for those with special educational needs and underrepresented in programs for the gifted. Although it is preached that having limited English proficiency is not a disorder, practice is quite different. Children who may lack a foundation in L1—a deficit that affects learning of English (L2)—

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are placed in English-only classes as soon as possible instead of allowing these children to remain in L1 programs until they have a sufficient base. In addition, most children remain in bilingual programs for only two or three years before being thrust into regular English-only classrooms. Although they may have gained some conversational proficiency with English, most do not possess sufficient English for classroom learning. It is estimated that it takes approximately five to seven years to attain such proficiency. These children often are referred for special education services on the basis of their classroom performance. In short, the cognitive/academic language proficiency (CALP) acquired in L1 can be transferred to CALP in L2. A unitary system of language provides a foundation for both languages. Enhancing either language enhances the entire system, although its effect on a specific language will vary. The child able to manipulate L1 in decontextualized situations has resultant facilitated learning in L2. Our present well-intentioned educational model is based on the belief that immersion in English is the best way to learn English. Children with a deficient base in L1 nearly always are placed in Englishonly programs despite the wishes of the child, family, or community. Quantity of input alone, however, is not the answer. Quality time spent conversing with an adult in English plus continued instruction in L1 could be much more beneficial at initial stages of language learning. Language in the typical English-only classroom is treated as one of many academic subjects. The typical classroom approach requires good metalinguistic skills that may be lacking in a child with an inadequate base in either language. The solution to this problem can be found, in part, in the model of intervention that we have discussed throughout this book. A child should remain in an L1 program until she or he has a sufficient language base. Later English-only training should be functional, reflect its ultimate use, and contain a top-down or communication-through-conversation focus. An individual must develop to a proficient level in one language to benefit fully from instruction in a second one. Children with LEP and children who are bilingual, taught linguistic concepts such as prepositions and pronouns in L1, and then instructed in L2 learn these concepts twice as fast as those taught only in L2 (Perozzi & Chavez Sanchez, 1992). Instruction in L1 facilitates acquisition in L2 (Kiernan & Swisher, 1990; Perozzi, 1985). In short, L1 provides input for comprehending L2. It is not true, however, that instruction in either language improves the other. Teaching vocabulary in L2 has little effect on L1 when the words are unknown in both (Perozzi, 1985). In an English-only classroom, the environment should stimulate use and facilitate production and comprehension of English. The teacher should act as facilitator and encourage group work that fosters language use. Language is meaningful and used for real communication. New vocabulary is introduced in context, bound to experiences, and associated to other words in the child’s lexicon. Language is integrated into other subject areas. The teacher’s speech is modified for vocabulary complexity and use of idioms. He or she speaks more slowly, uses simple sentences, and emphasizes and repeats key words to enhance comprehension. Although the teacher expects children to communicate and raises these expectations as they progress, he or she attempts to keep anxiety low and the motivation for language use high by employing the conversational feedback techniques discussed in Chapter 10. In the first stage, a teacher will want to focus on comprehension in which a child develops the ability to extract meaning from utterances directed to him. In this stage, the child listens and follows simple instructions, responding with gestures, body movements, names, and one-word answers. One type of extended listening experience is called total physical response (TPR), in which the child participates in active singing, rhythm, and movement activities that include language. Language is paired with non-

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Suggested Total Physical Response Materials

Before the Bell Rings, Prentice-Hall/Alemany Brown Bear, Brown Bear, What Do You See? Holt, Rinehart & Winston Chicken Soup with Rice, Harper Trophy The Children’s Response, Prentice-Hall/Alemany Here Comes the Cat, Scholastic Jazz Chants for Children, Oxford Look Who’s Talking, Prentice-Hall/Alemany The Magic of Music, Movement, and Make-Believe, DLM Mary Wore Her Red Dress, Clarion More Songs for Language Learning, Communication Skill Builders Movement Plus Music, DLM Oxford Picture Dictionary, Oxford Purple Cows and Potato Chips, Prentice-Hall/Alemany Songs for Language Learning, Communication Skill Builders Where Is Thumbkin? Gryphon House

linguistic elements of learning that happen to be a lot of fun. Suggested TPR materials are listed in Table 11.16. In the second stage, after six months or more of comprehension training with only minimal English production, focus is shifted to simple production with a strong receptive element (Heberle, 1992). The goal is limited English production with continued vocabulary growth. The facilitator uses yes/no and either . . . or questions with content that the child has used repeatedly in comprehension training. All production attempts are encouraged, and the child is not penalized for mispronunciation or errors of form. Production is usually at the one-word or phrase level. This stage of English training may last for approximately one year. In the third stage, the child is required to use a more extensive production vocabulary and to begin to use grammar more correctly. Again, communication, not syntactic learning, is the goal. The facilitator uses repetition and expansion, respectively, to reinforce and correct the child’s productions. Finally, the child progresses to the last stage, conversational fluency. The facilitator still will have to modify the linguistic context to aid the child’s production and comprehension. For children with LI, learning either language will be a challenge. It seems reasonable, therefore, to provide services in both languages, especially if the goal is to have a child function appropriately within her or his school, community, and family (Goldstein, 2006). Doing so may be the only way family members can participate in intervention, and it keeps a child’s L1 from deteriorating to the point of being isolated within his or her family. In addition, promoting skills in one language can be beneficial for the other, especially if an SLP targets features common to both (Kohnert & Derr, 2004). Unfortunately, some districts and states mandate that speech and language intervention occur only in English. I say “unfortunately” because such policies are shortsighted. For children living in the United States, it is their native language that is at risk, not English.

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Children with minority dialects offer a similar challenge. Minority dialects are neither crude approximations of the standard nor haphazard, unpatterned forms. Nor do they reflect disordered language or disorganized thinking on the user’s part. These dialects are valid forms of the standard language, and this validity should be reflected in the public schools. Notions of dialectal superiority reflect prejudicial thinking and have led to educational approaches aimed at eradicating minority dialects. The American Speech-Language-Hearing Association (1983) has labeled this approach “inappropriate.” Bidialectal education should be fostered instead. This approach recognizes the validity of dialects and also the educational and employment needs of the individual. Smitherman (1985) found that only those speakers of African American English (AAE) who master code switching, the successful use of both AAE and a second dialect closer to the standard, achieve educational success. Unfortunately, any discussion of bilingual or bidialectal education has become embroiled in political debate over what some educators call “Ebonics” and the acceptance of English as the only language for governmental use. As discussed previously, the SLP must not regard dialectal differences as language disorders. Language is impaired when the child demonstrates inappropriate, incorrect, or immature use within his or her dialectal community. This position suggests, therefore, that intervention should teach both minority and standard equivalents for disordered structures (Adler, 1988, 1990). For example, if the child with LI speaks African American English, use of the verb to be should be taught in both AAE and the standard. Only this approach truly serves the child, who must function within both a dialectal community and the larger society. In effect, the linguistic standard (SAE) is taught as a second dialect, or D2 (L. Campbell, 1993). D2, the dialect of education, is taught while maintaining the dialect spoken at home and/or in the community. The goal is not eradication of D1, but proficiency in an alternate dialect (O. Taylor, 1990). Using the child’s knowledge of D1, the SLP can teach the contrasting features of D2. Role-play can be used effectively to increase the child’s knowledge of both dialects and their use environments (Gee, 1989; Taylor, 1986b).

Use of Microcomputers Microcomputers can enhance language instruction when well integrated into an overall language program in a cohesive manner (O’Connor & Schery, 1989; Steiner & Larson, 1991). Primarily a drill-andpractice tool at present, the computer can complement—but should never replace—face-to-face learning situations. Children enjoy using computers. Preschoolers prefer computer-based training to traditional therapy drills and desktop activities (Shriberg, Kwiatkowski, & Snyder, 1989). Most training programs are user friendly, lowering the threat to children with LI. The goals of intervention and the methodology should be established prior to determining the role of the microcomputer and integrating it into the overall plan. It is all too easy to fall into the trap of allowing the computer program to determine intervention goals. This train-for-the-program approach is not individualized for each child. Children with LI are best served by microcomputers when both the child and the SLP actively participate, when computer use is individualized, and when software specific to the intervention goal is used. The most effective integration of the microcomputer occurs when the SLP or other facilitator and the child interact around the program being used, commenting and discussing choices offered and the child’s selections. In this way, computer programs can be tuned more to the needs of each child. Sim-

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ilarly, software designed to address specific language problems (Ertmer, 1986; Meyers & Fogel, 1985) is better than generic, mass-market software. Computer programs should be used with caution. Prior to using any program, the SLP should ask fundamental questions about its theoretical underpinnings, the design of studies reporting success, and the clients who will seem to benefit most from program use (Gillam, 1999). Of special concern for functional communication are the naturalness of the approach, its effect on overall communication, and generalization to real-life situations. Microcomputers seem especially useful for writing training. A four-step approach of prewriting, writing, revision, and publication can be used effectively to teach both writing and organizational skills (Cochran & Bull, 1991). Writing software includes Kidwriter, Explore-a-Story, and Explore-a-Classic for younger school-age children, and Logowriter. Speech synthesizers that can “read” the story heighten the child’s awareness of the audience and can have a positive effect on writing (Borgh & Dickson, 1986; Espin & Sindelar, 1988; Kurth, 1988; MacArthur, 1988; Meyer & Rose, 1987; Rosegrant & Cooper, 1987). Possible intervention activities are presented in Table 11.17.

TABLE 11.17

Integrating Computer Activities into Language Therapy

Sample Language Objectives

Giving directions Taking another’s point of view Sequencing events Summarizing information Taking another’s point of view Using verb tenses Initiating topic Using correct question syntax Maintaining topic Changing topic Closing conversation Carryover any new syntactic or phonologic skill Sequencing events Explaining what will happen Explaining what did happen

Word Processing Activity

Pre-/Postcomputer Activity

Extended Project

Copy a recipe Explain special terms or translate for younger children to use Write daily entry in “speech journal” (5 minutes at end of each session)

Make the recipe Tell others how it was done Take photograph of finished dish book and display

Collect recipes into a notebook

Write interview plan Write a “dialog” of the interview (focus on content, not punctuation) Based on the dialog, write a biography or story Write a project plan Write a letter asking for permission to have contest Make signs and invitations Write a letter inviting a newspaper or yearbook photographer to the contest After the contest, write an announcement of the winners to be read over the school PA system

“Publish” the recipe book and display with photographs

Make a success report for mom, dad, teacher Make “This is Your Plan what to write Life” display Watch videotape of Start a school interview on TV newsletter Interview someone familiar Hold a contest (cook, bus driver, music (bubble blowing, teacher) poster making, ball Role-play being the interthrowing, Twister) viewer or interviewee Discuss the therapy session

Plan a contest Discuss what will be needed Discuss what contestants must do Discuss what makes “news”

Source: Cochran, P. S., & Bull, G. L. (1991). Integrating word processing into language instruction. Topics in Language Disorders, 11(2), 31–49. Reprinted with permission.

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Conclusion Even though you may feel overwhelmed by all the recommendations in this chapter, we have discussed only a small percentage of the available intervention techniques. Limited space necessitates a rather cursory examination of these procedures. SLPs should seek further information in source materials or in published clinical materials. In addition, they will conceive their own creative and innovative methods for intervening with children with LIs. It is hoped that these methods will be adapted to fit the conversational model presented in Chapters 9 and 10. Not all specific language problems are treated easily with a functional approach, but the entire model does not have to be discarded. Caregivers, for example, are a valuable resource and can be used in various ways, whatever the specific language problem being targeted. Likewise, training can occur in meaningful contexts within everyday events.

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I

n school, children encounter the language of instruction, which is very different from the child’s previous conversational interactions (N. Nelson, 1985; Ripich & Spinelli, 1985). Language is treated in the abstract as children learn to talk about it and to manipulate it. Metalinguistic skills are very important (Gottschalk, Prelock, Weiler, & Sandman, 1997). The child with inadequate language skills or inadequate strategies for making sense of different situations is apt to become lost (N. Nelson, 1989). On an oral-to-literate continuum (Westby, 1985), school tasks are at the extreme literate end, requiring the child to understand and express information displaced from her or his own experiential base. Language itself creates the context within which information is conveyed. An SLP supports a child’s communication efforts in the following ways (Duchan, 1997): by modifying his or her role and modeling appropriate roles for the child and by creat• Socially, ing contexts in which the child can take varying roles. by preventing ostracism and by aiding the child to resolve conflict and to be tuned • Emotionally, to the needs of others. by redesigning contexts when needed by the child and by helping all children achieve • Functionally, their communication goals. by arranging the environment for maximum participation. • Physically, Communicatively, by providing scripts for participation. • The goal is for each child to be successful with diminishing adult support. Functional intervention treats language as it occurs throughout the child’s many experiences. Assessment and intervention that flow from this model stress language processing within a variety of relevant contexts, such as the classroom (L. Miller, 1989). A functional approach to intervention shifts the focus from the child as the source and solution of the language problem to a holistic view that includes the child and the child’s language uses and learning strategies, the contextual demands, the expectations and beliefs of other people within that context, the child’s interaction, the context, and the child’s communication partners (L. Miller, 1989). Thus, the focuses of intervention become the contexts that surround a child with LI and the manipulation of these contexts. The classroom’s cognitive activities are an excellent context for stimulating language growth (Moses & Maffei, 1989). Within the classroom’s constructive activities, children create, change, relate, and compare entities; set goals; encounter and try to overcome problems; make errors; reflect on success or failure; and note problem-solving procedures (J. Norris, 1989). The functional model discussed throughout this text can be adapted to these differing classroom needs. In fact, some of the recent changes in education, such as inclusion and collaborative teaching, espouse some of the same principles we have been discussing. In this chapter, we will examine these trends and propose some models of classroom intervention. Following that, we will describe the new role of the public school SLP and elements of a classroom intervention model, including specific intervention targets for preschool and school-age children. Finally, we will discuss implementation of classroom intervention.

Background and Rationale: Recent Educational Changes Language training within the school classroom offers a special challenge for an SLP and a classroom teacher. School systems throughout the United States and Canada are adopting and modifying many

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models of intervention to provide more appropriate and effective intervention. These new models reflect recent educational changes in inclusion and collaborative teaching. I NCLUSION Educational legislation in the United States has resulted in increased educational benefits for children with disabling conditions. One outcome of this legislation, intended or not, was two parallel educational systems: one for children developing typically and another for children with disabilities. Special education included separate placement, separate teachers, and a separate curriculum. Criticisms—just or otherwise—of the overall separate special-education model include the inherent segregation, the focus on labeling and categorization of children, the “slow it down, water it down” educational approach, and a general frustration with a “once in, never out” treadmill. Special services such as speech-language pathology usually were accomplished by removing a child from the classroom. As a result, the pull-out, or isolated therapy model, of intervention prevailed in public education (Marvin, 1987). The pull-out model tends to fragment a child’s intervention. Such patchwork schedules are extremely difficult for children with few strategies for making sense of the world. Increased need results in increased fragmentation until there is little continuity, and a child’s progress suffers as a result (Bashir, 1989). Usually, there is little generalization with the pull-out model, and the content of such intervention may be irrelevant to the child’s classroom needs (Anderson & Nelson, 1988). Beginning in the 1980s and continuing today, a movement has developed to raise education standards for all children. These changes have led to inclusive schooling and to the Regular Education Initiative (REI). Inclusive schooling is an educational philosophy that proposes one integrated educational system based on each classroom becoming a supportive environment (S. Stainback & Stainback, 1992; W. Stainback & Stainback, 1990). Instead of separate systems of education, inclusive schooling proposes a unitary system of education adaptive enough to meet individual children’s needs in a flexible manner. The result is (a) a shift in focus from the deficits to the abilities of children with special needs, (b) collaborative learning, (c) curriculum-based intervention, and (d) placement of all children in regular-education classrooms, with special services as needed (Silliman, 1993). REI is the movement toward an educational continuum that extends from regular-education classrooms for most children through regular-education classrooms with special services to adaptive environments for a small majority of the children most severely involved (Hoffman, 1993). At the latter end of the continuum, children will require services from trained professionals and curriculum-based intervention services to enhance their classroom participation. For example, in reading readiness training, children with LLD need explicit, systematic, and intense instruction in areas such as phonological awareness and letter-sound relationships (Silliman, Bahr, Beasman, & Wilkinson, 2000). Ideally, children developing typically will serve as models for children with LI, although integration alone may be insufficient. Model children developing typically are chosen carefully and trained in simple techniques that will facilitate communication for children with LI (Weiss & Nakamura, 1992). Children in self-contained special education classrooms often do not form friendships with children developing typically and thus often do not have typical peer models (Roller, Rodriguez, Warner, & Lindahl, 1992). The result is not an end to special education, but rather a change in emphasis and a new way of educating children. The intent of inclusive teaching is increased educational opportunity for all children. Change is not without its problems. More than a quarter of SLPs surveyed feel that inclusion is not appropriate for all children with LI even though it results in better carryover and provides good

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language models for these children (Bell, 1995). The most frequent complaints are that there are too many students to serve and not enough time for individual attention. COLLAB ORATIVE TEACH I NG The negative effects of pulling children out of class to receive speech and language services are not found when these services occur in the classroom. Ongoing classroom activities can serve as the basis for intervention, with content coming from a child’s assignments and projects and the interactions of the classroom (Wallach & Miller, 1988). Thus, intervention is relevant for the environment in which it is being used. In addition, a child can benefit from the social dynamics of the classroom (N. Nelson, 1988). The variety of formats for classroom intervention includes the following (Blank & Marquis, 1987; Catts & Kamhi, 1987; DeSpain & Simon, 1987; Dudley-Marling, 1987; L. Miller, 1989; Simon, 1985): 1. An SLP team-teaches with a regular classroom teacher and other specialists, usually the resource room teacher (J. Norris, 1989; Roller et al., 1992). This teaching may include both specialists teaching small groups simultaneously, or one specialist, such as the teacher, working with the larger class, while the other, such as the SLP, works with a smaller group. Goals and objectives, individualized educational plans (IEPs), and the monitoring and reviewing of individual programs are the team’s joint responsibilities. 2. An SLP provides one-on-one classroom-based intervention with selected students in the classroom by using course materials (N. Nelson, 1989). The intervention usually centers on language strategies for classroom use. 3. An SLP acts as a consultant for a classroom teacher and other specialists. As such, he or she advises (not supervises) personnel, assisting primary caregivers with intervention strategies. Consultative models of intervention usually involve joint goals and objectives that the classroom teacher implements. The SLP assists the classroom teacher in modifying curriculum, instruction, and assessment to facilitate the success of children with LI. Within a therapeutic partnership, the SLP helps the teacher set objectives, reinforce and modify behavior, and assess progress (Ehren, 2000). This collaborative consultation model is the one most frequently suggested in the professional literature (Marvin, 1987). This model is very flexible and may include elements of several other formats. Because this model has obvious advantages for generalization (Damico, 1987), it is the basis for discussion in this chapter. The model for discussion in this chapter incorporates some elements of each of these, although primary emphasis is on the collaborative format. Collaborative teaching is a combination of consultation, team teaching, direct individual intervention where needed, and side-by-side teaching in which a teacher and an SLP share the same goals for individual children (Montgomery, 1992a). In partnership, an SLP and the classroom teacher combine their efforts to serve children with LI. Parents are also members of the intervention team. The collaborative-consultative model stresses interaction and integration of the knowledge and expertise of the individuals involved (Confal, 1993). The approach is a problem-solving one in which all participants share the responsibilities of decision making, planning, and implementation. All aspects of speech and language services are built around the skills a specific child needs to function better in the classroom environment. That’s functional language intervention! The many evolving models of col-

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laboration vary with the SLP’s therapeutic perspective, the degree of child- and family-centeredness, the amount of guided inquiry and cooperative group work, discourse scaffolding, and prevention (Prelock, 2000). Within limits, children can select the focus of intervention just as they can select the topic of conversation. In this way, children have a stake in what is being learned. They are actively involved. This model includes, but is not limited to, the following elements: 1. An SLP provides in-service training for staff and parents. 2. A classroom teacher helps identify potential children with LI through observation of classroom behavior. An SLP evaluates the speech and language skills of these children and others who fail speech and language screenings. Such evaluations are an ongoing and integral part of the intervention process. 3. An SLP, classroom teacher, and aide provide individual and small- and large-group intervention services within the classroom and the curriculum. In addition, the SLP continues to provide individual or small group therapy outside the classroom to children in need. 4. A classroom teacher, aide, and parents interact daily with the children in ways that facilitate the development of language skills. The SLP is not a paraprofessional aide for the classroom teacher. Using communication situations occurring in the classroom, the SLP provides individual and group intervention within the classroom and conducts small group activities in which newly acquired language skills are used. Classroom training has been shown to be effective in increasing both elicited and spontaneous language production (Dyer et al., 1991; Haring, Neetz, Lovinger, Peck, & Semmel, 1988; Koegel, Dyer, & Bell, 1987; Koegel & Johnson, 1989; Scott, 1995). For example, with very young children, a classroom intervention model for teaching an initial lexicon is superior to individual intervention methods in generalization of learned words (Wilcox, Kouri, & Caswell, 1991). When an SLP and classroom teacher plan collectively but work independently in the class, even children not enrolled in language intervention benefit. In short, the collaborative classroom model is both effective and cost-efficient (Langenfield & Coltrane, 1991). These results reflect the more numerous natural opportunities for communication and the many potential language facilitators in a classroom (L. Miller, 1989). Ideally, the classroom provides an interactive model in which language features are modeled and embedded in familiar, ongoing activities (Cole & Dale, 1986; N. Nelson, 1989; Snyder-McLean & McLean, 1987). Real conversations and meaningful activities provide motivation and experiences that are usually not available in isolated individual intervention (Bricker, 1986). Activities are meaningful and experience based. The SLP, teacher, and other children respond to a child’s naturally occurring communication (Bricker, 1986; Fey, 1986). SU M MARY Educational trends, including inclusive schooling and collaborative teaching, have combined to change the teaching and remediation of language. In many schools, an SLP is working with children and their language impairments within a naturalistic language curriculum in regular education classrooms. The principles we have been discussing in this book are a near perfect match to the demands of this intervention situation.

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Role of the Speech-Language Pathologist Any classroom intervention model raises questions about the SLP’s role and about others’ expectations of the intervention team. There are no quick answers. The model of intervention that evolves is a blend of the child’s needs and the desires of the school, the individual teacher, and the SLP. Ideally, the SLP will assume the roles of co-teacher, consultant, and direct service provider and will be integrated fully into the classroom (Farber, Denenberg, Klyman, & Lachman, 1992). The SLP is the school’s language expert. As such, he or she advises administrators, teachers, and special needs committees about children and language impairment. The SLP is also responsible for speech and language assessment, for the planning and implementation of all speech and language programming, for record keeping, and for training personnel who will work with the children with LI. R E LATI NG TO OTH E R S Functional intervention in the classroom necessitates coordination of intervention goals and schedules. This coordination requires that an SLP interact daily with a variety of individuals. Classroom Teachers The SLP is uniquely qualified to assist a classroom teacher in assessing each child’s level of functioning, analyzing the language requirements of various activities and materials, and developing intervention strategies in conjunction with the classroom teacher. This is an ongoing process, accomplished through in-service training and individual consultation and training, as well as with co-teaching within the classroom. Both teachers and SLPs rank team teaching and one teach/one drift as the most appropriate model for collaborative teaching (Beck & Dennis, 1997). Team teaching is supplemental teaching in which one team member adapts the material for children with LI. In one teach/one drift, one member teaches and the other assists students as needed. The SLP and the classroom teacher have unique skills that they can use to help each other and a child with LI. The SLP understands language development and the remediation of speech and LI. The classroom teacher knows each child and understands the use of large and small group interactions for teaching. Difficulties usually arise over turf or territory. The classroom teacher may feel threatened by the presence of another “teacher” in the classroom and may resent being shown how to talk to students to maximize each child’s language learning. The SLP may feel like a classroom aide, undervalued for his or her expertise. Any potential problems should be discussed openly prior to beginning intervention. Each professional’s role should be delineated and clearly understood. This ongoing exchange is especially important at the beginning of intervention. It is imperative that the SLP avoid the “tutor trap” in which she or he becomes a glorified classroom aide (J. Norris, 1997). Classroom requirements should not dictate clinical content. In addition, the SLP should work to enhance the classroom environment as well as to change the child’s language. It is important to retain a therapeutic focus. This requires the interrelated steps of planning and implementation (Ehren, 2000). Planning requires intervention services for children that target skills underlying the curriculum. In implementing intervention, the SLP should focus on the goals for children on the caseload and not on general educational activities. Examples of classroom dos and don’ts are presented in Table 12.1. The role of the SLP is not to provide specific curriculum teaching or tutoring nor to relieve the teacher of the responsibility to teach all students in the class.

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Examples of Dos and Don’ts of Classroom Speech and Language Services

Do . . .

Don’t . . .

Help child to identify the important information on a math worksheet and decide on a way to perform the operation.

Help the child complete the math problems.

Teach relevant vocabulary by focusing on the words and figurative language of the science text that may be difficult for the child with LI, and encourage the teacher to establish a language learning center.

Preteach the science vocabulary next chapter.

Co-teach a social studies lesson by guiding the students with LI to practice the language strategies learned in therapy. Simple note cards containing reminders can be given to each child.

Co-teach a social studies lesson for all students without addressing the IEP goals of the children with LI.

Source: Adapted from Ehren (2000).

The SLP and the classroom teacher are part of the intervention team and should contribute in that fashion. Each has special expertise to impart. Parents Not all parents can or wish to participate in their children’s speech-language intervention. Parents tend to fall into three identifiable groups, the largest being those who desire participation. Next are those who desire no participation, and the smallest group is composed of parents who only want more information (Andrews, Andrews, & Shearer, 1989). The first group of parents can be involved in planning and implementation of intervention, and parents who want information can be served through parent meetings and in-service training. School Administrators Administrators may not understand generalization and the need to provide language remediation within the classroom. Caseload dictates and contact hour requirements may have to be modified to accommodate the classroom model. Both teachers and SLPs agree that finding enough consultative time is a big problem (Beck & Dennis, 1997). Discussion should center on how best to serve the children and how to use professional time commitments most efficiently. LANG UAG E I NTE RVE NTION AN D LANG UAG E ARTS Classroom teachers and administrators are sometimes confused about the difference between language arts and language remediation. Unless this distinction is clear, the SLP’s role also may be misunderstood, especially as it relates to classroom intervention. Through training, teachers and administrators become aware of the distinction and of the valuable contribution of each to the child’s education. Language arts accomplishes several things:

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1. Provides children with labels for the language units they have been using in their speech. 2. Requires children to stretch their language abilities into new areas, such as fictional and expository writing. 3. Enables children to have language growth experiences, such as performances. 4. Helps children reason and problem solve by using linguistic units. All of these valuable accomplishments presuppose that each child has a well-formed language system. Children with LI are at risk of failure. In language remediation, a child is taught language features that are not present or are in error in the primary mode of communication—that is, in language transmitted via speech. Secondary modes, such as reading and writing, are a concern when problems with oral language affect them.

Elements of a Classroom Model The classroom model consists of identification (assessment), intervention, and facilitation. In each phase, the classroom teacher and the SLP, although a team, have individual inputs that affect the delivery of quality services for a child. I DE NTI FICATION OF CH I LDR E N AT R ISK Teachers play a vital role in identifying children with LI. Most teachers are not trained in language development or impairment, and the SLP must alert them to the behaviors that signal a possible impairment. Teacher training can be accomplished through in-service sessions. Teachers also can be given aids to use in identifying a potential language problem. Table 12.2 presents a list of some signs for recognizing children having difficulties in the classroom. Table 12.3 or its adaptation might be used by teachers for referral to the SLP.

TABLE 12.2

Recognizing Children with Language Impairment in the Classroom

The child may have some or all of the following: Seems to fail to understand and follow instructions. Is unable to use language to meet daily living needs. Violates rules of social interaction, including politeness. Lacks ability to read signs or other symbols and to perform written tasks. Has problems using speech to communicate effectively. Demonstrates a lack of appropriate organization and sequence in verbal and written efforts. Does not remember significant information presented orally and/or in written form. May not recognize humor or indirect comments. Seems unable to interpret the emotions or predict the intentions of others. Responds inappropriately for the situation. Source: Adapted from N. Nelson (1992).

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TABLE 12.3

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Teacher Referral of Children with Possible Language Impairment

The following behaviors may indicate that a child in your classroom has a language impairment that is in need of clinical intervention. Please check the appropriate items. _____ Child mispronounces sounds and words. _____ Child omits word endings, such as plural -s and past-tense -ed. _____ Child omits small unemphasized words, such as auxiliary verbs or prepositions. _____ Child uses an immature vocabulary, overuses empty words, such as one and thing, or seems to have difficulty recalling or finding the right word. _____ Child has difficulty comprehending new words and concepts. _____ Child’s sentence structure seems immature or overreliant on forms, such as subject-verb-object. It’s unoriginal, dull. _____ Child’s question and/or negative sentence style is immature. _____ Child has difficulty with one of the following: _____ Verb tensing

_____ Articles

_____ Auxiliary verbs

_____ Pronouns

_____ Irregular verbs

_____ Prepositions

_____ Word order

_____ Irregular plurals

_____ Conjunctions

_____ Child has difficulty relating sequential events. _____ Child has difficulty following directions. _____ Child’s questions often inaccurate or vague. _____ Child’s questions often poorly formed. _____ Child has difficulty answering questions. _____ Child’s comments often off-topic or inappropriate for the conversation. _____ There are long pauses between a remark and the child’s reply or between successive remarks by the child. It’s as if the child is searching for a response or is confused. _____ Child appears to be attending to communication but remembers little of what is said. _____ Child has difficulty using language socially for the following purposes: _____ Request needs

_____ Pretend/imagine

_____ Protest

_____ Greet

_____ Request information

_____ Gain attention

_____ Respond/reply

_____ Share ideas, feelings

_____ Clarify

_____ Relate events

_____ Entertain

_____ Reason

_____ Child has difficulty interpreting the following: _____ Figurative language

_____ Humor

_____ Emotions

_____ Body language

_____ Gestures

_____ Child does not alter production for different audiences and locations. _____ Child does not seem to consider the effect of language on the listener. _____ Child often has verbal misunderstandings with others. _____ Child has difficulty with reading and writing. _____ Child’s language skills seem to be much lower than other areas, such as mechanical, artistic, or social skills.

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Teachers should be trained to observe and describe classroom behaviors as precisely as possible. The SLP’s complaint that teachers refer children who have rather nonspecific vocabulary problems or are inattentive reflects poorly on the SLP’s training of teachers in LI and its manifestations. Teachers are a valuable source of raw data on classroom performance when they know what to observe and measure. In addition, the SLP and the classroom teacher can identify the individual classroom’s or grade level’s special communication requirements as a gauge against which each child can be measured to assess achievement. Called curriculum-based assessment, this method uses a child’s progress within the school curriculum as a measure of her or his educational success (Tucker, 1985). Children are assessed against the curriculum within which they are expected to perform. Thus, intervention focuses on changes in the child’s behavior that are relevant to the educational setting. From preschool through high school, the curriculum changes in the types of demands made on each student. These changes are as follows (Wiig & Semel, 1984): Preschool: Learning focuses on sensorimotor, language, and socioemotional growth with materials that are manipulative, three-dimensional, and concrete. Early grades (K–2): Learning focuses on perceptual-cognitive strategies with materials that are one-dimensional, abstract, and symbolic. Middle grades (3–4): Learning places higher demands on linguistic and symbolic skills with less direct instruction. The child is expected to make inferences, analyze data, and synthesize information. Upper grades (5–6): Learning focuses on content areas, with the child expected to recall past learning and display fluency with basic academic skills. Middle and high school: Learning emphasizes lectures in content areas, with students expected to reorganize material as they listen and to gain the main or important points. From 75 percent to 90 percent of the day may be spent receiving information. Some school districts have identified skills that children need to succeed in each grade. Table 12.4 presents some of the skills needed in the first three grades. In addition to the school’s official curriculum, which is an outline of the material to be learned in each grade, children encounter several other curricula (N. Nelson, 1989). These include the de facto curriculum that is actually taught and the cultural and school curricula needed to succeed within each context. The expectations of the latter are often very confusing for the child with language-processing problems. The implicit expectations of individual teachers and other children form a fourth curriculum. The SLP first must become familiar with the curricula that affect the individual child with LI. He or she can assess the child through a combination of interview and observation of the child’s ability to meet the language demands of the curricula. The interview phase can provide information on the curricular expectations, and observation can focus on the specific linguistic demands made of the child. An analysis of the linguistic demands must consider all aspects of language and the many reception and production modes. Such an analysis also should note metalinguistic skills demanded in these various aspects and modes (N. Nelson, 1989). An educational language assessment focuses on a child’s oral and written abilities and capacity to learn, rather than on his or her deficits (Silliman, 1993). Data are gathered by direct testing and reallife observation within the classroom. The level of support necessary for learning is determined, including evaluation of the effectiveness of various instructional and intervention strategies. Most standardized tests are too global, and more specific measures should be used to measure the child. The parents and the teacher, as well as the child and the SLP, should participate.

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TABLE 12.4

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Some Possible Language Skills Needed in the First Three Grades

First Grade. The child will be able to: Recognize correct word order auditorily. Identify singular and plural common nouns and proper nouns. Identify regular and irregular past and present verbs. Identify descriptive and comparative adjectives. Use nouns and pronouns, adjectives, and verbs correctly in sentences, including verb-noun agreement. Give and write full sentences. Categorize words by opposites, by sequence, by category, and as real/nonreal. Retell a story. Identify the main idea in a paragraph. Classify narrative and descriptive writing. Rhyme words and identify words that begin with the same sound. Identify declarative and interrogative sentences and use correct ending punctuation for each. Capitalize the first word in a sentence, days, months, people’s names, and the pronoun I. Alphabetize. Give directions and explanations and follow two-step directions. Read aloud. Listen attentively and courteously to others. Second Grade. In addition to the skills needed for first grade, the child will be able to: Use correct word order. Identify incomplete sentences. Recognize singular and compound subjects of a sentence. Identify possessive and plural nouns, contracted verbs, and superlative adjectives and use correctly. Capitalize holidays, titles of people, books, stories, and places. Identify correct comma use. Use an apostrophe in contractions. Identify the topic sentence and sentences that do not relate in a paragraph. Write an explanation or set of directions. Address an envelope. Write rhyming words to complete a poem. Identify figurative language and synonyms. Recognize characters, plot, setting, and the major divisions in a story or play, and the difference between fiction and nonfiction. Tell and write a clear, original story. Use the title page and table of contents in a book. Use the dictionary for spelling and meaning. Read critically for sequence, main idea, and supporting details. Use tables and graphs as sources of information. Recognize types of poetry. Listen discriminately for rhyming, sequences, and details. Third Grade. In addition to the skills needed for first and second grade, the child will be able to: Identify imperative and exclamatory sentences, simple and compound sentences, and run-on sentences. Recognize compound predicates in a sentence. Recognize articles and conjunctions in sentences. (Continues)

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TABLE 12.4 (Continued) Some Possible Language Skills Needed in the First Three Grades Use an exclamation point. Use an apostrophe in possessive nouns. Define a paragraph and identify the main idea and supporting sentences. Write a paragraph, a book report, and a letter with correct capitalization and punctuation. Write a clear, original story with title, beginning, middle, and end. Recognize the difference between biography and autobiography. Use a dictionary for pronunciation. Use an encyclopedia, telephone book, newspapers, and magazines as references. Identify compound words, homophones, and homographs. Use prefixes and suffixes. Read critically for sequence, main idea, and supporting details. Organize information by category and sequence. Recognize real and make-believe, relevant and irrelevant, and factual and opinionated statements. Identify characteristics of different types of narratives.

The SLP follows up these reports and collects her or his own data within the classroom setting. These data can be corroborated by further testing and sampling. Teachers and parents should be informed about the results of testing and sampling and advised on the best methods of intervention. Classroom teachers should be involved intimately in the intervention process. Assessment with Preschool Children With preschool children, an SLP is interested in pragmatic abilities, semantics, especially the child’s lexicon; language structure; and narrative form and story grammar rudiments. Additional areas of importance for literacy education include role-play and representational play, decontextualization, and adaptations for non-oral responding (Culatta, 1992; Culatta, Horn, Theadore, & Sutherland, 1993; Westby, 1988). Play is particularly important for preschool children, especially as a context within which to experiment with language (Westby, 1988). Of particular importance in play are the level of decontextualization, thematic content, organization, and self/other relations (Culatta, 1992; Culatta et al., 1993; Westby, 1988). Play can be very context-bound, using only real objects, or relatively decontextualized, using imaginary or symbolic objects. The familiar versus unfamiliar themes of play are also important for later intervention. The organization of play can demonstrate cohesion, logical connections with the theme, and planning. Finally, the roles a child takes and assigns may be important for later training and may tell an SLP something about the child’s ability to take the perspective of others and to style switch. Decontextualization in a child’s language is important for later reading and is demonstrated by reference to nonpresent entities and to past and future tense. Reading is very decontextualized because all meaning comes from print and little from the physical context. Even though a child cannot read, pre-literacy skills are important for further development. An SLP is interested in a child’s comprehension of text, knowledge and awareness of print, and sound-symbol associations and decoding abilities. Finally, non-oral methods of communicating are important. These include gestures, facial expression, and body posture, but also drawing and “writing.”

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Assessment with School-Age Children and Adolescents In addition to considering the language features mentioned in Chapters 5 through 8, the SLP is interested in the child’s language as it relates to the specific requirements of the classroom. An authentic, or real, assessment should be a train-test-train procedure, with both the SLP and the classroom teacher acting as “participant observers,” determining the best instructional strategies for individual children (Silliman, 1993). Such an evaluation consists of systematic observation of real teaching and learning in the classroom that yields meaningful information on student progress on an ongoing basis. Systematic observation might include rating scales and checklists, narrative records, and descriptive tools by the teacher, SLP, and student (Silliman, Wilkinson, & Hoffman, 1993). Possible rating scales for use with school-age children and adolescents are listed in Table 12.5. Teacher logs, notes, journal entries, and student assignments and self-evaluations should be gathered to ascertain the child’s oral and written language skills. Of interest is the amount of scaffolding or structure and assistance needed by a child for success. Interviews with the student are also helpful (N. Nelson, 1992). Students can be asked to describe their most difficult and easiest subjects and their strengths and weaknesses, to relate recent classroom events that made them feel bad and to prioritize changes they would like to make in themselves and in the classroom and manner of instruction. The SLP may gain additional information by informally sampling the child’s performance. For example, the SLP might compare a secondary school child’s notes with those of a higher-performing student in the same class (Larson & McKinley, 1987). Audio recordings of classroom instructions can TABLE 12.5

Tools for Assessment of Classroom Skills

Observation/Interviews

Clinical Discourse Analysis (Damico, 1991a) Environmental Communication Profile (Calvert & Murray, 1985) An Interview for Assessing Students’ Perceptions of Classroom Reading Tasks (Wixson, Bosky, Yochum, & Alvermann, 1984) Pragmatic Protocol (Prutting & Kirchner, 1983, 1987) Self-Attribution of Students (SAS) (Marsh, Cairns, Relich, Barnes, & Debus, 1984) Social Interactive Coding System (SICS) (Rice, Snell, & Hadley, 1990) Spanish Language Assessment Procedures: A Communication Skills Inventory 3rd edition (Mattes, 1995) Spotting Language Problems (Damico & Oller, 1985) Systematic Observation of Communication Interaction (SOCI) (Damico, 1992) Testing

Classroom Communication Screening Procedure for Early Adolescence (CCSPF-A) (Simon, 1989) Curriculum Analysis Form (Larson & McKinley, 2003) Interactive Reading Assessment System–Revised (Calfee, Norman, & Wilson, 1999) Lindamood Auditory Conceptualization Test, 3rd edition (Lindamood & Lindamood, 2004) Pre-Literacy Skills Screening (Crumrine & Lonegan, 1998) Test of Awareness of Language Segments (Sawyer, 1987)

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be analyzed to determine the level of complexity that each child must be able to process. The SLP might collect samples of the child’s oral reading or help the child complete assignments, noting the child’s language-related work skills. Within the classroom, children use language for self-monitoring, directing, reporting, reasoning, predicting, imagining, and projecting thoughts and feelings. Also of interest is the breadth of functions demonstrated in conversation and narration. School semantic features include abstract terms, refinement and decontextualization of word meanings, the ability to define words, multiple word meanings and figurative language, organization of a semantic network, and use of metalinguistic and metacognitive terms (N. Nelson, 1985; Pease, Gleason, & Pan, 1989). Semantic networking, or relating ideas to a theme, is an important skill for children to acquire (Heimlich & Pittelman, 1986). Those with better-formed, more-extensive networks are better able to comprehend and follow a topic or theme (Westby, 1990). Networks can be evaluated by having the child name everything he or she can related to a given topic or category or place pictures and words into categories. Picture tasks can be made more challenging by the use of pictures with differing perspectives. Success in the classroom requires that a child be able to explain decision making, to discuss mental processes, and to reflect on mental processes of others and him- or herself (Wellman, 1985). Metalinguistic and metacognitive terms are listed in Table 12.6. Some terms are acquired prior to school age, but many are not mastered until adolescence. Syntax and morphology gradually change throughout the school years. Initially, structure is more complex in oral language rather than in written, but this reverses. Therefore, the SLP is interested in the structure of both. (See Chapters 6 through 8.) Analysis would include clause and T-unit length and elements of the noun phrase and verb phrase. Cohesive elements such as pronouns and conjunctions are especially important (French & Nelson, 1985; Nippold, 1988). Poor readers and writers often have poor cohesive skills and are unable to go beyond a single sentence or bit of information (Irwin, 1988). Linguistic cohesion relies on a set of semantic and syntactic relationships or ties, such as reference, substitution, ellipsis, conjunction, and lexical. Questions based on the student’s reading can be used to evaluate comprehension of text cohesion. Reading and writing are discussed in detail in Chapter 13. Narrative and expository writing and speaking also should be analyzed. Difficulty at these levels may signal underlying problems. Pictures can be used in an assessment to elicit both oral and written samples. Of interest are the clarity of cohesion and the types employed (Irwin & Moe, 1986). For children with word-finding difficulties, the SLP can analyze reading and writing errors to determine the strategies used by the child. Even though a word is incorrect, it may be semantically or syntactically acceptable. For example, in the following sentences incorrect words may or may not make semantic or syntactic sense. Target:

ch12intbl01

He went into the house. He went into the home. He went into the hotel. He went into the heavy.

Semantically and syntactically acceptable Syntactically acceptable but semantically unacceptable Semantically and syntactically unacceptable

The types of substitutions made may highlight the type of processing—auditory or visual—being used by the child. In an auditory strategy words may sound the same; in a visual, they may look similar. Categorization strategies may also be revealed in which the child has the correct category but the wrong member.

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TABLE 12.6 afraid confirm guess know sad

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353

Common Metacognitive and Metalinguistic Terms assert disgusted happy mad surprised

assume doubt hypothesize predict talk

believe embarrass imply propose think

concede feel infer proud understand

conclude forget interpret remember

Word substitutions may signal word-retrieval problems. A curriculum-based assessment should attempt to identify the discrepancy between the child’s knowledge of classroom content and his or her ability to retrieve it (German, 1992). The SLP should note the presence of word-finding strategies discussed in Chapters 3 and 7. Auditory discrimination and articulation skills are important for spelling and should also be assessed. Similarly, phonemic awareness is important for writing and reading. As language becomes more complex in school-age and adolescent years, the assessment and intervention tasks also become more challenging. Add to this deficits found in reading and writing and the task becomes even more formidable. Reading and writing assessment and intervention will be discussed in Chapter 13. CU R R ICU LU M-BASE D I NTE RVE NTION Children with LI may need assistance transitioning from preschool to kindergarten and elementary school (Prendeville & Ross-Allen, 2002). Not only is the child-to-adult ratio increased but children are also expected to work increasingly in small groups and to negotiate using language. In addition, there is also increased expectation for a child to work independently while receiving less individualized support. The curriculum is different and language based, as is the manner of instruction (Rosenkoetter, 1995). Children need instruction and activities that help them “bridge” to the curriculum (Masterson & Perrey, 1999). Planning for each child’s transition should be systematic, individualized, timely, and collaborative involving both the family, classroom teacher, and SLP. Through collaborative intervention, the SLP can model interactive teaching styles and help the teacher to combine listening, speaking, reading, and writing activities into each lesson but structured in such a way as to ensure success for children with LI (Farber & Klein, 1999). Within the classroom, an SLP can work with individuals or small groups of children and adolescents while the teacher works with the rest of the class. Group projects can provide the context for intervention by using the techniques discussed in Chapter 10. Other children can serve as models. Small group instruction is efficient and effective and increases generalization and interaction (Shelton, Gast, Wolery, & Winterling, 1991). Children’s individual needs can be addressed if the SLP or teacher carefully interacts with each child in ways that foster the targeted aspects of language. Signs posted conspicuously can remind the teacher or aide how to interact with each child to maximize language intervention. With planning, adults can accomplish such training individually even in groups of children. The goals of classroom intervention are for a child to learn new ways of communicating and to have ample opportunity to practice newly acquired skills (McCormick, 1986). The environment should be responsive so that a child learns that language can have some effect on that environment. The language of effective classroom communicators is characterized by fluency of word-finding skill,

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coherence or content organization, and effectiveness and control (National Council of Teachers of English, 1976). A child’s learning within the classroom is a function of individual learning style and the environment. Both must be considered when assessing or attempting to intervene with learning. The language of a child’s classroom and materials can provide the context and content for intervention. With advancing grades, the emphasis shifts increasingly to independent work and to listening and note-taking abilities. Rules become implicit and children are expected to work independently (Westby, 1997). Each of these tasks is extremely complex. Intervention helps students learn strategies for analyzing various tasks and for determining the steps to take to accomplish them. The SLP might teach language-impaired students time management skills, study skills, critical thinking, and language use (Buttrill, Niizawa, Biemer, Takahashi, & Hearn, 1989). He or she might develop a book of listening activities for teacher use within the classroom (Cosaro, 1989). Other innovations that might help children with LI organize their day and make sense of the classroom include encouraging use of a daily planner, helping teachers add graphic input to lectures, defining concepts and vocabulary, cuing to guide reading comprehension, developing guided questions to help children make inferences, discussing how to answer questions, and helping children to identify main ideas for note taking (J. Norris, 1997). Study skills training might include text analysis, study strategies, note taking, test-taking strategies, and reference skills. Through text analysis, a child can be helped to understand the organization of texts and their more efficient use. Study strategies might include active processes for reading, such as identifying the main ideas and reviewing periodically to organize the material. Children also can learn associative and other memory strategies. Critical thinking is the collection, manipulation, and application of information to problem solving. Language is an integral part of this process. Therefore, a child with LI may experience difficulties with organizing information and with decision making. Likewise, sophisticated metalinguistic judgments also would be difficult. Critical thinking training might target the three components of general thinking, problem solving, and higher-level thinking (Buttrill et al., 1989). General thinking includes observation and description, development of concepts, comparisons and contrasts, hypotheses, generalization, prediction of outcomes, explanations, and alternatives. Problem-solving skills include analyzing the problem into smaller parts, developing options, predicting outcomes, and critiquing the decision. Higher-level thinking includes deductive and inductive reasoning, solving analogies, and understanding relationships. These tasks become increasingly more abstract and require greater reliance on linguistic input. Analogies are particularly difficult for children with LLD. Analogical reasoning can be taught through a two-phase model in which steps for solving analogies are taught in Phase I and bridging activities to specific academic areas are taught in Phase II (Masterson & Perrey, 1994). Phase I targets the following skills: Encoding. Inferring. Mapping. Applying.

Translating each term into an internal representation of its attributes. Establishing the relationship of the first pair. Using the first relationship to identify a similar one in the second pair. Picking the answer that has the same relationship as the first pair.

Activities and instruction are presented in Table 12.7.

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Training Analogical Reasoning Skills

Phase I: Mediated Instruction

Session 1

• • • •

The four component processes are presented and defined. Applications of the processes are demonstrated by the instructor. Students apply the processes in the solution of a horse: a picture of a foal: a picture of a cow: (a picture of a calf) and perceptual analogies ( : :: : ) Students participate in group practice problems and in independent practice in the form of worksheets.

Session 2

• •

Component processes are applied to verbal analogies. Review the previous day’s lecture, move to group practice, and end with individual practice.

Session 3

• • • •

Component processes are used during reading activities. Students begin with analogies in sentence form (e.g., “At night we seen the moon, but in the day we see the?”). Analogies at the paragraph level are presented (e.g., “Astronauts are much like the pioneers of the Old West . . .”). The importance of identifying key phrases such as it is like, similar to, and for example that potentially signal analogies in spoken and written communication is discussed.

Session 4

•

A story is read to the students and they must describe other situations that would be analogous to the story, offering both explanations and justification for their decisions.

Session 5 • Focus is on encoding skills. • The students are given a topic, such as dinosaur eggs. • They brainstorm as much general information as possible about eggs, such as how eggs look, how they are used, etc. • They then choose a list of attributes that are specific to the topic (i.e., dinosaur eggs) and rate the attributes by importance. Session 6

• • •

Focus is on inferring skills. Before reading a story, students look at the pictures that are included. They offer hypotheses about which elements seen in the pictures will be relevant to the outcome of the story.

Session 7

• • •

Focus is on mapping skills. Students list the characters in a story, along with their attributes such as personality and physical characteristics and/or jobs or other roles in the story. They then compare and contrast the characters on the basis of these attributes.

Session 8

• • •

Focus is on application skills. Students answer comprehension questions at the end of a story. They discuss potential sources of information (e.g., generated by the reader or found in the text) that can be used to solve questions. (Continued)

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TABLE 12.7

•

(Continued) Training Analogical Reasoning Skills

Using this information for discussion, the students then work through the questions to find the most appropriate response.

Phase II: Bridging

Session 9, Science

• • • • •

Measurement skills are addressed. Session begins with a discussion of different forms of measurement and when each is appropriate. Students then discuss situations in which one measurement must be converted into another. The use of maps may be chosen as the example. Students will then draw the classroom to scale on the chalkboard. Session ends with students generating other situations in which one form of measurement must be converted to another.

Session 10, Language Arts

• • •

Students read the story The Giving Tree by Silverstein. Students generate a list of attributes for the boy and the tree and then use these attributes to compare and contrast the characters. Students then describe other relationships that are analogous to the boy and the tree.

Session 11, Interaction with Peers

• • •

Various social situations dealing with peer interactions are presented to the class, such as teasing, peer pressure to use alcohol/drugs, vandalism, and shoplifting. Students discuss and/or role-play possible ways to handle each situation and talk about the advantages and disadvantages of each solution. Emphasis is placed on using experience gained from past interactions to determine appropriate solutions for present scenarios.

Session 12, Life Skills

• •

The instructor helps the students work through a situation in which a recipe that feeds four people must be increased to feed all the people in the class. The students then generate other situations in which determination of the solution would be analogous to increasing a recipe.

Session 13, Social Studies

• • • •

Current events such as pollution, gun control, or television ratings are discussed. The instructor leads the students in discussion of past events that are analogous to current events (e.g., child labor laws, prohibition). Students then generate a list of possible future events that would also be analogous. The use of principles or laws that have proven to be either helpful or harmful in the past will be discussed in relation to current or future events.

Session 14, Recreation

• • •

Activities focus on money. Students are given an “allowance” for which they must formulate a budget containing specific items. The instructor helps the students generate analogous “budgets,” such as time management or nutritional/diet-control systems.

Session 15, Vocational Day

•

Activities deal with interactions with adults.

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(Continued) Training Analogical Reasoning Skills

This session follows the format of Session 11, but focuses on relationships with adults such as parents, coaches, and teachers. Topics may include following rules, dress codes, and punctuality. Students talk about analogous relationships they may encounter in the future, such as employer, spouse, or government institutions such as the IRS.

Session 16, Math

• •

The instructor helps the student determine the best buy when presented with two sale ads (e.g., 1 cassette for $3.94; 3 cassettes for $9.99. Which is the best buy?) Students discuss other analogous situations in which such comparative information would be important.

Source: Reprinted with permission from A program for training analogical reasoning skills in children with language disorders by J. J. Masterson and C. D. Perrey. Language, Speech, and Hearing Services in Schools, 25, 268–270. Copyright © 1994 by American Speech-Language-Hearing Association. All rights reserved..

With increased emphasis on lectures at the secondary level, listening skills become even more important. In general, good listening skills are highly correlated with good overall language performance. Students can be taught to tune in to what they hear and to listen actively. Subsequent training can focus on recognition and understanding of lecture material. The child’s semantic, syntactic, and morphological repertoire can be expanded as a base for comparison with new information from lectures. Such training might include word meanings, relationships and categories, sentence transformations, active and passive voice, embedding and conjoining clauses, and segmentation (Buttrill et al., 1989). Through critical listening training, a child learns to supply missing information, complete stories, find important information, and recognize absurdities in spoken information. In oral language production, a child can express the language repertoire trained receptively. In addition, the child can sharpen word-retrieval and figurative language skills. The SLP can teach children to verbalize important critical reasoning skills, such as questioning, comparing, and analyzing, and to discuss a task or topic and to give examples. Elementary school children and adolescents can also be taught metapragmatic awareness in order to judge inconsistencies, inadequacies, and communication failures. The SLP can help students with LI understand response requirements for relevancy and thoroughness (Gottschalk et al., 1997; Kaufman, Prelock, Weiler, Creaghead, & Donnelly, 1994). An SLP can enhance written-language training by using computers and topics of interest to the child. Computer intervention can have a positive effect on language, especially vocabulary, and even can improve social-interactive skills (Schery & O’Connor, 1992). Organizational skills gained in critical thinking training can be used in expressive writing training. Finally, an SLP can enhance conversational skills by role-playing and practice. The child with LI can be helped to identify different communication contexts and their requirements. Written information can be used to train oral language skills. Within a conversational or small group framework, written scripts can be used for practice in communicating between speaker and listener (J. Norris, 1989). Written material can be controlled systematically to ensure that it is well organized and cohesive and that it offers a variety of topics, roles, and situations. Prewritten textual information allows the SLP to teach language holistically, using all aspects of language, rather than fragments (Laughton & Hasenstab, 1986). The use of social interactions enables the child to learn language as an integrated social-cognitive-linguistic experience.

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Adolescents can offer a special challenge if they are not treated with respect or included in intervention decisions. The structure of an adolescent’s day highlights the need for some stability in the teen’s language input. These students need more time than short classes allow. In addition, each teacher’s contact with individual students is limited to class periods. No one is responsible for the teen’s overall language functioning and success (Larson, McKinley, & Boley, 1993). Essential to any successful adolescent program is destigmatization and the awarding of academic credit. Rooms selected for language group classes should be mixed with other classes. Classes should have names similar to other classes, such as “oral communication skills,” rather than “speech therapy.” The giving of credit aids motivation and gives the SLP clout and credibility (Larson et al., 1993). A program such as Contextualized Adolescent Language Learning (CALL) Curriculum (Ehren & Mullins, 1988) may serve as a model. It consists of two strands, academic and functional. The academic portion targets items in the regular curriculum, while the functional emphasizes immediate daily living demands. Academic targets can be emphasized by the SLP during classroom teaching. The overall intervention model might incorporate elements of two instructional approaches called strategy-based and systems models. The strategy-based intervention model assumes that learning problem-solving strategies is more powerful than learning factual content and will generalize more readily (McKinley & Lord-Larson, 1985). Teaching includes strategies for verbal mediation and for the organization and retrieval of linguistic information (Buttrill et al., 1989; J. Norris, 1989; Tattershall, 1987; Wallach & Miller, 1988; Wiig & Semel, 1984). This model is highly appealing because of its potential for generalization outside the intervention setting. In contrast, a systems model assumes that the source of the language impairment lies in the interactions of the child, the primary caregivers, and the content to be learned (N. Nelson, 1986a). Intervention strategies should reflect the child’s varying learning needs across several learning contexts (N. Nelson, 1989; Wallach & Miller, 1988). Although classroom group intervention may suffice for some children with mild language problems, others will need individual services. This service can be accomplished in the classroom, through the more traditional pull-out model, or both. The functional conversational model is still very appropriate, as noted in Chapter 7. Children also may work individually within the classroom, using computer-aided instruction (Schetz, 1989). The SLP can demonstrate individualized targets and techniques for the teacher with the child or discuss them in meetings with the child’s teachers, aides, and parents. Parents who cannot receive instruction in individualized training techniques are better used as general facilitators, rather than as direct trainers. Language facilitator education can be accomplished in in-service workshops and at parent meetings. The SLP should not try to impart all of his or her knowledge to teachers, aides, and parents at these meetings. A general outline of language development and an introduction to principles of instruction will suffice. LI NG U ISTIC AWAR E N ESS I NTE RVE NTION WITH I N TH E CLASSROOM In addition to providing individual or group services within the classroom setting, an SLP can increase linguistic awareness itself for all children. Within such activities, an SLP can be especially mindful of the needs of those children with LI. Each child should be encouraged to participate at her or his ability level.

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Preschool Whole class, preschool, preliterate activities may include replica and role-play, narrative development, and the use of children’s books. Each contributes to the general notion of narration and narrative form and is important for literacy. Replica and Role-Play Play and narrative development are very similar (Westby, 1988). For children developing normally, the language of social make-believe play and the language of literacy have similar functions (Pellegrini & Galda, 1990). Language must be modified for the audience or participants, meaning must be conveyed, language is elaborated, and there are cohesive ties and integrated themes. The imaginative function of language is acquired during preschool through social interactional play. The language is very explicit in order to convey meaning crucial to directing such play (“You be the baby now”). Language is used to refer to objects within the situation (“This is my horse”) and to negotiate and compromise (“Okay, you can talk like that if you’re the baby”). Integrated themes are evident in the beginnings and ends of play episodes, in the temporal organization, and in the enactment of everyday events or previously heard or seen narratives (Pellegrini, 1985). Imaginative language is heavily influenced by context. Both boys and girls prefer replica toys, such as dolls, a simulated store, dress-up, and boys also prefer blocks. Replica toys reflect the real word. Toys generally are used as props for their intended purposes. Older preschoolers and kindergartners are more willing to use ambiguous props and to assign meaning (Pellegrini & Perlmutter, 1989). Preschoolers use language forms in their play that later are used in school literacy events. For example, verbs used in play are a good predictor of reading ability later. Reading is often in the temporal sequential mode similar to the narratives found in play. Play has been used effectively to increase language skills of preschool children developing typically. Children can make significant gains in play-related conversation, vocabulary, and sentence lengthening. Unfortunately, many children with disabling conditions do not play like children developing typically (Westby, 1988). Sometimes, they do not have the experiential base for play. Children are more likely to engage in interactive communication when they share a social script. Children with LI often are isolated in the regular preschool class, engaging in solitary play. Given the importance of play for later narrative development, it is essential that these children have normalizing play interactions. As mentioned previously, play is assessed within the framework of an overall communication assessment. The SLP is interested in play analysis relative to decontextualization of props and language, thematic content of the scripts presented, organization, and the roles assigned by a child to him- or herself and others (Culatta et al., 1993; Westby, 1988). Also of interest are emerging literacy skills (Culatta et al. 1993; Edmaiston, 1988). These skills include recognition of situationally dependent print, such as a stop sign; independent interactions with a book; book handling skills; book knowledge, such as retelling, asking questions, and pointing to a page and its parts; and letter and sound recognition. Prior to beginning play training, an SLP must plan the event carefully (Culatta et al., 1993; Sonnenmeier, 1992). First, he or she must create a play script. Theme selection should be based on a child’s familiarity with the theme or script and the child’s level of play. It is best to begin with everyday events. Table 12.8 presents events based on familiarity. For a child unfamiliar with replica play, the SLP might select getting ready for school or going to the market. By providing a supportive context, familiar routines are natural events within which language occurs. Our goal throughout this text has been for the child to have language that works in everyday situations.

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TABLE 12.8

Themes for Training Replica Play

Every Day

Once in a While

Very Seldom

Fantasy*

Getting ready for school

Baking a cake

Going to the zoo

Having a birthday party

Going to the circus

Being the teacher (police, grocer, mommy, etc.)

Getting dressed

Going to a birthday party

Seeing a parade

Being a dinosaur

Going on a boat ride

Going to Mars

Riding on the school bus

Getting a haircut

Going on an airplane

Piloting a plane

Going to the doctor

Going in the car

Visiting _____

Going to the market

Getting a bath

Celebrating (holiday)

Going to an amusement park

Being a caveman hunting animals

Going to church or temple

Going to a show/concert

Eating lunch

Painting a picture Flying with wings

Eating at McDonald’s *To preschool children

Some events emphasize roles; others emphasize sequences. For example, riding on the school bus is more role-dependent, while making a cake is sequential. Different types of events should be chosen over time to aid generalization. A note of caution is in order. Event representations vary with cultures. A child in a preschool classroom from a different culture may not readily adapt to the event chosen. Even within the “American culture” experience, children respond differently on the basis of race and ethnicity, family income and education levels, and geographic location. Next, the SLP determines each child’s involvement in planning and develops the script. Children unfamiliar with play should be very involved in planning so that the play can be explained and have some contextual reference. The script should begin with one sequence and progress to multischeme events. More detail should be added gradually, along with more story grammar components. Once children have progressed through this type of replica play, they can reenact selected texts from children’s books. Appendix F includes a list of children’s books for reading and enactment. The use of literature is discussed in following sections. Decisions will need to be made about roles, props, repetitive elements in the narrative, and elaboration. In general, children with disabling conditions should be assigned initially to familiar roles. Props should be real objects. Gradually, roles can be modified and reassigned, and prop use can become more decontextualized and symbolic. Table 12.9 presents a possible format for the training of play. The script is presented first in such a way as to provide a context for play. General play and the specific theme of this particular play are discussed with children the adult models the appropriate roles, children re-create the event. This step is replayed many times with varying roles and elaboration of the basic theme.

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Sequence of Sociodramatic Script Training

Step 1: Present script. Step 2: Model roles including spoken parts. Step 3: Have children re-present event and script. If needed, teacher prompts children for turn changes and for what to say and do. Prompting decreases over time. Prompts for motor-gestural response. Tell child what to do and give full physical prompt. Gradually decrease the prompt to a partial one and then to a physical assist. Tell child what to do and gesture or point. Tell child what to do. Point or gesture. Ask child, “What do you do next?” Prompts for verbal response. Ask child to imitate and present child with model (“You say, ‘I want a hamburger’ ”). Ask child to imitate and present a partial model (“You say. ‘I want ...’ ”). Tell child it’s his/her turn and gesture or point. Point or gesture. Repeat prior child’s behavior and ask, “What do you say?” Ask, “What do you say to X (other child’s role)?”

Step 4: When children are familiar with roles, reassign. Offer fewer prompts.

Step 5: Modify roles and script. Source: Adapted from Culatta, Horn, Theadore, & Sutherland (1993); Goldstein, Wickstrom, Hoyson, Jamieson, & Odom (1988); Sonnenmeier (1992).

At each juncture, children are encouraged to describe and discuss the event enacted. The language of such group discussion and decision making is important for school success and helps more firmly stabilize learning. Narrative Development Training for narrative development and production is similar in many ways to that for play and may occur at the same time or following more elaborate forms of replica play. Gradually, the events become more decontextualized through the use of puppets or cutouts and imaginary or substituted objects. Children can take turns narrating the story as it continues. After decontextualized enactment, the narrative is related to the group and retold. With retelling, sequences can become even more elaborated so that a familiar event such as getting ready for school is modified with late arising, no clean socks, burnt toast, no toothpaste, a flat tire, and so on. Preschoolers must be cautioned to stay within the story frame. You do not get attacked by giants at the market nor rescued by the Power Puff girls on the school bus.

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Gradually, the SLP can introduce stories with familiar event sequences that have not been enacted by the children. These, too, can be retold and modified by the children. Finally, children’s literature can be used and these narratives retold by the children. Children’s Literature Significant differences exist in the activities and interactions with print for children with LI and those developing typically (Marvin & Wright, 1997). These differences are reflected in the poorer letter knowledge, interactive reading skills, story-listening abilities, and discussion of reading skills of children with LI. The normalizing benefits of interactive reading with these children are very important. Sharing children’s literature with preschoolers is not just reading to them. Prereading, reading, and postreading activities can enhance the experience and make it more meaningful, while bonding the class together (Montgomery, 1992a; Owens & Robinson, 1997). Children’s literature must be presented to children within a framework that makes sense for each child. Books should be introduced by their title and related to world knowledge that children already possess. The following is an introduction to Brown Bear, Brown Bear, What Do You See?: I’m going to read a book today called Brown Bear, Brown Bear, What Do You See? This is the cover. First, what is a bear? It’s like a ... That’s right, Angel. Angel said a bear is like a big dog. Where does he live? Does he live in your house? No, he doesn’t live in your house. Does he live in your neighborhood? Good, Antonio shook his head “No.” He doesn’t live in your neighborhood. I wonder if he lives in the woods. Yes, he lives in the woods. And in the zoo, good, Shawna. Now, this bear is brown; he has brown hair. Who has brown hair? John, point to someone with brown hair. That’s your hair, John. Point to ... yes, Billie Sue has brown hair. Put up your hand if you have brown hair. Good, Maria ... and Katie ... and Michel. And my hair is ... That’s right, Angel, black hair just like you. Well, our bear has brown hair. Here’s a tough one: Do bears have any other color hair? ... As is obvious, the children can bring a lot of information to the task. When the story is read subsequently, each child can use her or his personal knowledge to interpret the story. Notice in my example that some children were allowed to respond by pointing. The SLP can ensure that every child has an opportunity to participate and facilitates their success by structuring their participation. Often, children with LI do not understand books, temporal and causal sequences, story grammars, or logical consequences. The SLP can guide them. Within the classroom, books might be used for chanting, rhyming, or predicting activities or for specific language targets. Art activities, sequential memory, and consequential language (if ... then) can follow reading. These activities and several resource books are listed in Appendix F. Books can be discussed with children at several levels of discourse and semantic complexity. These levels are presented in Table 12.10. School-Age and Adolescent Schools require extensive language skills from their students. Reading and writing are an essential part of the educational system. SLPs can encourage language use and aid development for those experiencing difficulties by actively engaging in classroom intervention. Skills targeted in intervention sessions

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Levels of Discourse and Semantic Complexity

Discourse levels of book discussion Collection: Descriptive list: Ordered sequence Reactive sequence: Abbreviated structure: Semantic complexity of book discussion Indication: Label: Description: Interpretation: Inference: Evaluation: Metalanguage:

Relatively unorganized list Utterances coordinated through a central topic Organized by temporal order Organized causally Includes psychological intent and planning Nonlinguistic signals, such as pointing Naming concrete, observable objects and agents Characteristics and relationships Observable characteristics used to refer to internal states, motivations, and underlying qualities Own background used to go beyond observable characteristics in a situation Likes/dislikes, justifications, summarizations Language applied to reflect on the way language is organized and used

can be enhanced in classroom application. Classroom linguistic awareness activities might include structuring classroom activities for success and metapragmatics. When asked to identify language targets that would facilitate successful communication interactions in high school, teachers highlighted the following as most important: relating narratives, presenting differing points of view or thoughts logically, employing conversation clarification and repair strategies, taking a conversational partner’s perspective, and taking turns appropriately (Reed & Spicer, 2003). Structuring Classroom Activities When children find school too frustrating, success too elusive, they give up. Different learning contexts within the classroom can reduce feelings of failure. For example, a noncompetitive environment can keep students task-involved, rather than ego-involved. Motivation is the key. Motivated students are more persistent. An SLP can make all students aware of the metacognitive and metalinguistic aspects of learning and employ strategies that enhance their application. He or she can explicitly teach learning strategies and provide guided practice and feedback. Each student can be guided and encouraged to participate at his or her functioning level. Students can be aided in recognizing the features that influence comprehension and recall and the processing and retrieval demands of a task. General comprehension strategies to be taught include self-monitoring, drawing inferences, and resolving ambiguities. Study strategies that might be targeted include paraphrasing, summarizing, and note taking (Seidenberg, 1988). Metapragmatics Children with LI are often unpopular and may seem odd or out of place in the dayto-day communication so common in the classroom. Among teenagers, perspective taking, comprehension of vocal tonal changes signaling emotion, and nonverbal communication are considered

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important communication skills (Henry, Reed, & McAllister, 1995). Everyday communication is important for classroom success and can be improved by intervention focusing on metapragmatics. Metapragmatic awareness is a conscious awareness of the ways to use language effectively and appropriately. More precisely, it is the knowledge of common ways of communicating, the ability to detect and judge inconsistencies, inadequacies, and failures, and the flexibility to change communication behaviors in order to increase efficiency (Gottschalk et al., 1997). An SLP can improve metapragmatic awareness by presenting examples of good and poor communication, discussing the differences with students, and role-playing appropriate communication. Video-recorded examples of communication may also be employed. Gentle critiques and self-evaluation are essential. Within this model, children have learned to ask questions and to respond effectively (Kaufman et al., 1994). With the entire class, an SLP can explore strategy-based language intervention (Wiig, 1995). Strategy-based language is used by mature speakers and is characterized by goal identification and fluent, flexible, and efficient communication to reach that goal. The mature speaker is able to take and express another person’s perspective and simultaneously formulate and test several communication hypotheses for effective language use. Within intervention, students can be taught to recognize patterns of social communication, to develop options and evaluate their effectiveness, and to organize communication behaviors to integrate communication goals, strategies, and perspectives. Using scripted social drama as the vehicle for holistic training, an SLP can guide students through the following four steps of training (Wiig, 1995): 1. Awareness of pragmatic features and underlying plans, scripts, and schemes. For example, topic initiations can be signaled by phrases such as That reminds me . . . , Speaking of . . . , You know . . . , Well . . . , and By the way. 2. Extending pragmatic awareness to real-life situations. 3. Generalization training across different media, contexts, and partners. 4. Self-directed training to foster independence. At each level and following each scripted drama, the SLP and students discuss feelings and reactions, identify alternative strategies, and apply the lessons learned to communication situations within their own lives. The SLP acts as coach while providing scaffolding and support. Conversational narratives may be taught in a similar manner by first identifying the purpose of a narrative and then constructing the appropriate form to fulfill that function. Sequencing and cohesion can be addressed as the narrative unfolds. Children can be helped to identify the cohesive ties, such as sequencing, word substitutions, conjunctions, and topic-comment relationships. Children from CLD backgrounds might benefit from style-switching activities and an awareness of appropriate use (Fleming & Forester, 1997). Role-playing can provide valuable lessons. Syntactic structures also can be taught within verbal interactions (Scott, 1995). Awareness activities might begin with modeling. The SLP can “think out loud” and discuss his or her options in a given conversation. Embedded within highly interesting conversations, other activities might include sentence combining and detection and correction of errors. Summary An SLP can provide classroom language instruction that addresses the needs of the entire class while enabling every child to participate. The SLP can provide the linguistic scaffolding that teachers often fail to provide, helping children become meaning makers and be successful. In addition, he or she can provide preteaching for the child with LI, helping that child be successful.

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LANG UAG E FACI LITATION Language facilitation includes (a) identifying the needs of certain contexts and giving children the opportunity to experience this context successfully and (b) talking to children in ways that facilitate growth and highlight production. The classroom is a special context with its own demands. Facilitative techniques can be used there and in conversational interactions between children and their teachers, parents, and peers. Classroom Language Requirements Much of the classroom training should focus on the interactional patterns between facilitators and the child with LI. Most teacher–child classroom interactions consist of providing the right information. The child provides the correct answer and then is quiet. This behavior does not encourage an interactive conversational pattern. Whereas conversations are relatively egalitarian and observe the rules of turn taking, classroom interactions usually are controlled by the teacher, who allocates turns. In contrast, conversational partners are not expected to guess the correct utterance the other desires, as children must do in classroom responding. Finally, conversational turns may be expected but only rarely required. In the classroom, the teacher asks questions that require responses. Certain question forms are difficult for children with LI. Some demand statement of fact, whereas others expect a child to reason and explain processes that may require inductive or deductive reasoning. Table 12.11 presents ten rules for classroom participation (Sturm & Nelson, 1997). Often, the type of language used in the classroom is very different from what a child experiences at home. For example, the teacher’s language consists of many indirect requests and statements. Questions or statements such as “Can you show us where the answer is written?” and “I can’t hear Lori because others are being impolite” contain requests or demands. There is still plenty of room for conversational give-and-take in nondidactic (non-questionanswer) exchanges, however, and these contexts also must be considered. Children have classroom time to participate in social conversation. Classroom programs and materials can be manipulated to maximize the opportunity for such necessary interactions.

TABLE 12.11

Ten Rules for Classroom Participation

Teachers mostly talk and students mostly listen, except when teachers grant permission to talk. Teachers give cues about when to listen closely. Teachers convey content about things and procedures about how to do things. Teachers’ talk becomes more complex in the upper grades. Teachers ask questions and expect specific responses. Teachers give hints about what is correct and what is important to them. Student talk is brief and to the point. Students ask few questions and keep them short. Students talk to teachers, not to other students. Students make few unsolicited comments and only about the process or content of the lesson. Source: Adapted from Sturm & Nelson (1997).

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Often, work in the classroom occurs in small groups concerned with some common project. Groups should reflect the classroom’s composition, with opportunities for children who are high- and low-functioning to interact. The skill of knowing how to get things done in the classroom is not usually taught to children, but rather is taken for granted by teachers (Wilkinson & Milosky, 1987). The lack of such knowledge can be problematic for a child with LI asked to work with others to accomplish some task. A child must be able to request and give information, action, and materials and to make judgments on the correct language and communication behaviors in and out of context. Each child is expected to be able to identify the information needed by all involved to complete a task and also to judge the appropriateness of information that is given. Classroom language functions include the following: socially to others while stating personal needs. • Relating Directing and self. • Requestingothers and giving • Reasoning, judging, andinformation. • Imagining and projectingpredicting. into nonclassroom situations. • Relating socially to others while stating one’s own needs contains a number of behavior categories, such as referring to psychological or physical needs (“I want to leave now” or “I’m hungry”), protecting one’s self and self-interest (“That’s mine”), agreeing or disagreeing (“You’re wrong”), and expressing an opinion (“I hated that dessert”) (Staab, 1983). The “directing self and others” function includes the categories of directing one’s own actions, directing the actions of others, collaborating in the actions of others (“You be the mommy, and I’ll be the daddy”), and requesting direction (“How do you do this?”). This function can be elicited by requiring children to accomplish some task they cannot do without help. There will also be a need to direct others and to follow others’ directions. The “giving information” function includes labeling (“That’s a piñata”), referring to events (“Yesterday, we got a kitty”), referring to detail (“That kitty is black and white”), sequencing (“We went to the party, and then we went to the movies”), making comparisons (“Yours is bigger”), and extracting the general point (“We’re making Hanukkah presents”). To elicit this function, the child shares an experience with someone who did not originally share it, as in show-and-tell (Staab, 1983). Often, classroom discussions involve activities in which the entire class has participated, and children do not feel the need for relayed information to be as precise or detailed. They presuppose that their classmates share much of the information. This same presumption cannot be made when classmates do not share the information. Requests for information vary with the type of information sought. For example, adults and children tend to use more direct requests when there are few, if any, obstacles to receiving the answer, as in checking short answers to problems (Francik & Clark, 1985). In this situation, the request is very direct: “What’s the answer to number 4?” As children mature, they learn to identify the type of information needed to help a requester. In general, children become more aware of the importance of information specificity. Children are also more likely with maturity to provide information on the process of solving a certain problem, rather than just the answer requested. In responding to the previous question about problem number 4, the child might try to presuppose the difficulties of the requester and respond, “5/8; I converted to 8ths

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after solving the problem in 16ths.” School-age children who provide specific information and process explanations are more likely to be high achievers (Peterson & Swing, 1985). The “reasoning, judging, and predicting” function includes explaining a process (“When you get lost, you should find a police officer”), recognizing causal relationships (“The bridge fell because it was weak”), recognizing problems and solutions (“This box is too small; get another one”), drawing conclusions (“We couldn’t finish the project because there wasn’t enough glue”), and anticipating results (“If we pull this cord, the bell should ring”). In general, problem-solving tasks, such as designing or building an object, will elicit this function. Problem solving includes predicting, testing hypotheses, and drawing conclusions. Finally, the “imagining and projecting” function includes projecting feeling onto others (“I think Carlos is afraid of the ghost”) and imagining events in real life or fantasy (“I’m captain of the spaceship Izits. All aboard”). This function can be elicited by fantasy play. Many activities can be projected into imaginings by asking children to imagine that they are some character in a story or what they would do in a particular situation. With older children, different situations can be role-played. To be successful, children must be able to use all of these language functions with some facility. As noted, activities can be designed to aid this growth. Talking with Children Adult interactions with children should facilitate language growth and learning. In a nonthreatening way, whenever possible, the SLP should observe and comment on the use of language by teachers and parents. Teachers are often unaware of the effect their language has on the processing of children with LI. For example, teachers’ oral directions can contain a large proportion of figurative expressions and indirect requests that are difficult for children with L1. (Lazar et al., 1989). Teachers respond to the initiations of children with LI below the optimal level (Pecyna-Rhyner, Lehr, & Pudlas, 1990). In general, teachers reply infrequently and, often, in a manner that terminates the interaction. The teacher’s frequent use of directives also may limit child-teacher interactions. The SLP can efficiently introduce teachers, aides, and parents to facilitative conversational techniques at in-service training sessions or parent meetings. The SLP should help teachers, aides, and parents understand the importance of adult modeling and responding to communicative behaviors. He or she should attempt to decrease the directive style of some parents and teachers in favor of a more conversational approach. The SLP can provide teachers, aides, and parents with examples of good interactive styles. A handout, such as that in Table 12.12, is often helpful. The SLP should stress the importance of different facilitator behaviors and the need to tailor techniques to the child’s individual style and language level. Whenever possible, the SLP should review these techniques and use them in demonstration with the individual child. Teachers, aides, and parents then can attempt certain facilitative behaviors while the SLP observes. Peers as Facilitators Classmates developing typically can serve well as models and can be taught functional strategies that promote interaction (Goldstein & Strain, 1988; Handekman, Harris, Kristoff, Fuentes, & Alessandri, 1991; Odom, Hoyson, Jamieson, & Strain, 1985; Wilkinson & Romski, 1995). For example, play interaction between children with LI and peers developing typically increases the play scripts of the children with LI (Robertson & Ellis Weismer, 1997).

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TABLE 12.12

Guide for Parents’ and Teachers’ Interactive Style

1. Talk about things that the child is interested in. 2. Follow the child’s lead. Reply to the child’s initiations and comments. Share his or her excitement. 3. Don’t ask too many questions. If you must, use questions such as how did/do ..., why did/do . . . , and what happened . . . that result in longer explanatory answers. 4. Encourage the child to ask questions. Respond openly and honestly. If you don’t want to answer a question, say so and explain why. (I don’t think I want to answer that question: It’s very personal.) 5. Use a pleasant tone of voice. You need not be a comedian, but you can be light and humorous. Children love it when adults are a little silly. 6. Don’t be judgmental or make fun of a child’s language. If you are overly critical of the child’s language or try to “shotgun” all errors, the child will stop talking to you. 7. Allow enough time for the child to respond. 8. Treat the child with courtesy by not interrupting when he or she is talking. 9. Include the child in family and classroom discussions. Encourage participation and listen to his or her ideas. 10. Be accepting of the child and of the child’s language. Hugs and acceptance can go a long way. 11. Provide opportunities for the child to use language and to have that language work for him or her to accomplish goals.

Sociodramatic or replica play can provide a basis for interaction for preschoolers. With schoolage children, many alternative activities can foster interaction and carryover (Hazel, 1990). Training young children with LI to play with toys has little effect on social interaction. Targeting social skills, such as inviting others to play, is more effective (Kohler & Fowler, 1985). Pairing is very important. For example, Male children with ID seem more likely to respond to male peers than female, although individual children will differ (Wilkinson & Romski, 1995). Classmates developing typically can be taught to increase communication interaction using a few simple steps. Questions seem to facilitate naturally occurring communication more than directive prompts, although males with ID respond more to comments by peers (Wilkinson & Romski, 1995). Although specific techniques for cuing and prompting can be taught to peers, these are relatively ineffective and time-consuming to teach. The fewer strategies taught, the better. One effective method, presented in Table 12.13, is to teach interactive strategies rather than teaching techniques to the TD peer and then to prompt and reinforce these strategies (Goldstein & Strain, 1988). This approach can increase interactions and on-topic responses by children with LI (Goldstein & Ferrell, 1987; Goldstein & Wickstrom, 1986). Several precautions seem relevant (Goldstein & Kaczmarek, 1992). Strategies should do all of the following: only behaviors observed in high-quality interactions. • Include Have a high of inducing the subsequent behavior. • Not place thelikelihood child with LI in a subservient role. • Not target language features take a great deal of effort or time to teach. • Have the potential to producethatbalanced and sustainable interactions. • Optimize typical social interaction, not simplify it. •

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Training Peers as Facilitators in Preschool Classrooms

Step 1: Teach peer to interact. Introduction Explain purpose: To help friend “talk” better. Model with another adult. Direct instruction. Children rehearse and adults critique. Adults take role of child with disabilities. Posters provide reminders.

Step 2: Prompt and reinforce use of strategies taught. Gradual change with less adult input and fewer peer facilitators and more children with disabilities. Teacher prompts (“Remember to have your friend look at you first,” “Remember to point”). Adults should try not to interrupt too much—inhibits children. Whisper or point to posters. Source: Adapted from Goldstein & Strain (1988).

Peer strategies reportedly continue when teacher prompts decline. Peers can also serve as effective tutors in narrative learning (McGregor, 2000). One small set of facilitative principles to use with preschool peers can be stated as stay, play, talk (Goldstein, English, Shafer, & Kaczmarek, 1997): Stay close to your buddy Play together, use the other child’s name, and attend to the same objects Talk while you stay and play This phrase plus adult modeling, guided practice, and independent practice with feedback and discussion of what it means to be a buddy and of the unconventional communication of some children can provide a model for effective peer training. School-age peers can be encouraged to interact through cooperative learning, homework monitoring, and language contracts (Hazel, 1990). Cooperative learning fosters interdependence and individual accountability while encouraging face-to-face interactions and interpersonal skills. Students with different language abilities are paired for classroom language projects and rewarded for group achievement (Danserean, 1987). Homework monitoring is another paired activity. A child who has the skills needed to accomplish the assignment helps a child with LI. The SLP works with both to help them complete their homework, uses role-play to teach the tutor and tutored roles to the tutoring peers, and critiques role-played interactions between the tutors. In addition, the SLP monitors the peers when actual tutoring begins. Finally, language contracts can be used to decrease inappropriate language behavior (Hazel, 1990). Both the child with LI and the classroom peers must be able to identify the behavior and understand the need to decrease its occurrence. For example, one child with Asperger’s syndrome continually

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touched other children annoyingly. The contract with the class defines the behavior and specifies the cues to reduce the behavior and to elicit a more desirable behavior. It is helpful in eliciting peer cooperation that the class be solicited for suggestions for decreasing the behavior. The contract is reviewed periodically and peers reinforced for success.

Instituting a Classroom Model The most difficult aspect of the classroom model is its initial institution. The transition from pull-out service to classroom-based, or “push-in,” service takes careful planning. Central to success is the resolution of the following issues: Training of the SLP Training of other professionals Establishment of a clear source of authority and responsibility for intervention Administrative support in the form of adequate space, scheduled time slots, and financial commitment (L. Miller, 1989) Identification criteria for students to receive services based not on standardized test scores but on classroom language processing and use (L. Miller, 1989) Responsibility for IEPs (L. Miller, 1989) The task of changing an entire model of intervention seems overwhelming. It may take three to five years to fully implement a collaborative classroom intervention model. The process is one of evolution (Ferguson, 1992b). It is essential to begin slowly and to prepare parents and other professionals for the change. The final model will vary with student needs and teacher/SLP flexibility (Brandel, 1992). The teacher and SLP will need to consult for general language activities and for specific language support of individual children. First, the individual SLP must train him- or herself. This training includes education in the use of a functional conversational approach and in the school curriculum (Montgomery, 1992b). This text provides one step in that education. Workshops, convention presentations, observation, and further professional reading are also essential. In addition, the SLP should role-play the use of various techniques because they differ considerably from the more traditional behavioral patterns. The SLP might begin by using core curricular materials in intervention (Moore-Brown, 1991). Classroom teachers can help the SLP become familiar with small and large group instruction. Possibly, the SLP could spend an hour per week in some group activity within a classroom. Second, the SLP will need to market collaborative teaching in order to recruit teachers and enlist administrative support (Prelock, Miller, & Reed, 1995). A quarterly newsletter and increased visibility at curriculum meetings will educate faculty about the role of the SLP. The SLP can discuss support for language goals in the classroom and inclusion of curricular goals in intervention. Informational meetings, breakfasts, and parent meetings can also be used with demonstrations and video-recorded presentations. Administrators can be approached individually. The SLP can present a rationale for collaborative teaching, share scheduling, send brief memos of very successful interventions, invite administrators to attend sessions, and request time at parent events.

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Third, the SLP must train other people. The initial purpose of this training is to educate teachers and administrators about the need for classroom intervention. This is best accomplished with inservice training stressing (a) the importance of the environment for nonimpaired language learning, (b) questions of generalization, (c) the verbal nature of the classroom, (d) the practicality and efficiency of classroom intervention strategies, and (e) the need for and desirability of team approaches. A possible in-service training model is presented in Table 12.14 (Prelock et al., 1995). TABLE 12.14

In-service Training Model for Collaborating Teachers and Speech-Language Pathologists

Session I: Language in the Classroom: Getting Perspective on Collaborating, Sharing Roles, and Teaming Objectives: 1. To share the perspectives of participants involved in collaborative service delivery on meeting the needs of at-risk students and students with communication disorders in the regular classroom. 2. To recognize those roles shared by teachers and speech-language pathologists as they assess and intervene with students. 3. To understand a transdisciplinary philosophy for teaming, including role exchange, role release, and role support. Activity: Videotape Viewing of Collaborative Planning Meetings, Classroom Activities, and Follow-Up Session II: Normal Communication Development and Communication Disorders in the Classroom Objectives: 1. To understand normal communication and language development in school-age children. 2. To recognize communication disorders common to the classroom. 3. To understand the pervasive nature of language deficits in children with handicaps. Activity: Role-Playing an Initial Collaborative Meeting Session III: Identifying and Managing Classroom Language Demands: What Are the Scripts? Objectives: 1. To gain a broader understanding of the impact whole language and traditional classroom methodology have on the student with communications disorders. 2. To identify scripts in the classroom. 3. To explain a process-based approach for managing classroom language demands. Activity: Developing and Implementing a Communication Skills Script in the Classroom Session IV: Assessing Communication Problems in the Classroom: A Collaborative Approach Objectives: 1. To understand curriculum-based language assessment. 2. To provide a framework for collaborative assessment using language-based curriculum analysis, checklists, and observation logs. 3. To suggest ways of establishing collaborative data collection practices during classroom activities. Activity: Practicing Team Assessment Session V: Strategies for Managing the Language of Math Objectives: 1. To recognize the language complexity in the math curriculum and in text materials. 2. To gain skills in adapting curriculum materials for elementary students with communication disorders. 3. To learn strategies for collaborating with students to enhance their performance in math application, computation, and problem solving. (continues)

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TABLE 12.14

( Continued )

Activity: Explaining Math Problems in Third Grade Session VI: Using Literature in the Classroom Objectives: 1. To examine the development of oral and written language. 2. To learn strategies for implementing literature use in elementary classrooms. 3. To recognize and manage the reading difficulties of at-risk students and students with communication disorders. Activity: Sharing a “Rainbow of Writing” Session VII: Issues in Collaborative Service Delivery: Scheduling, IEP Development, and Conflict Resolution Objectives: 1. To explain a process for determining the type(s) of service delivery a student with communication disorders should receive.

2. To recognize the role of regular and special education teachers, parents, and students in developing IEPs for students with communication disorders.

3. To discuss barriers to effective communication when working with a team. Activity: Conflict Resolution Through Role-Play Source: Reprinted with permission from Collaborative partnerships in a language in the classroom program by P. A. Prelock, B. L. Miller, and N. L. Reed. Language, Speech, and Hearing Services in Schools, 26, 286–292. Copyright © 1995 by American Speech-Language-Hearing Association. All rights reserved.

Administrators may be reluctant to change current one-on-one pull-out services. A more functional classroom model can be presented emphasizing both inclusion and efficacy (Moore-Brown, 1991). It is also important to remember that some children still will require pull-out services for specialskills training. Collaborative teaching is better suited to training of general communication skills (Borsch & Oaks, 1992). Goals and objectives, probably modest at first, should be established prior to implementation (Dyer et al., 1991). At each step in implementation, administrators need to be kept informed of progress. Several alternative models for collaboration are available (Russell & Kaderavek, 1993). Peer coaching and co-teaching seem especially promising. In peer coaching, the SLP and the classroom teacher work as a team, coaching each other through observation and feedback, commenting on effective teaching strategies (Schmidt & Rodgers-Rhyme, 1988). In co-teaching, each professional focuses on his or her component of instruction on the basis of the curriculum goals of the class. The teacher and the SLP jointly determine student needs, develop goals and objectives and activities to meet them, implement these plans, and evaluate progress (Holzhauser-Peters & Andrin-Husemann, 1990). Once convinced of the need for such a model of intervention, teachers can begin to learn specific intervention techniques. These techniques may be introduced in in-service training, with individual instruction to follow. Videotaped lessons including children with LI are excellent training vehicles to demonstrate the use of various techniques. Professionals conducting the training should be credible, knowledgeable, and practical. Appropriate materials and hands-on experience are essential to teacher training.

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Fourth, clear lines of authority for language intervention must be established. It is vital to the success of this model that roles and responsibilities, as well as authority, be clearly established. This step requires administrative support and a definite statement of policy. New roles and responsibilities should be written into the curriculum, budget, and job descriptions. This step is not a power struggle. No one is in charge of the collaborative intervention. Rather, responsibility is shared and roles shift within the classroom (Prelock et al., 1995). Fifth, administrative support in the form of space, scheduled time, and necessary financial outlays must be established. It is all too easy for administrators to declare a change in procedures without giving adequate support to ensure success. The biggest single impediment to implementation is the lack of time (Montgomery, 1992a). The SLP and the classroom teacher must allow time each week to discuss each child’s success and to review targets and techniques. Unfortunately, administrators often are unwilling to grant time for these conferences. My experience is that these meetings often occur over lunch or during breaks in the schedule. Although this arrangement is less than optimum, it does allow these essential interactions to occur. A scheduled meeting time of at least a half hour per week is preferred. Administrators also have difficulty seeing the need to lessen dependence on standardized measures of language. Language test scores offer a quantifiable measure of behavior that can be used for determinations of student needs and progress. Yet, similar measurement can be made against the curriculum and from conversational samples. The implementation of this step requires the joint educational effort of the SLP and the classroom teacher. Finally, IEPs will need to be written or modified to reflect the change in service delivery. Other members of the intervention team, including parents, will need to be educated on the rationale for such changes. Parents usually accept the classroom model when shown the increased service that their child will receive if the classroom teacher is also a language trainer. Many parents are also happy with the decreased amount of pull-out time. The implementation phase should progress slowly and carefully because it is new to both the SLP and the classroom teacher. At first, one child in one classroom can be targeted. This can gradually be expanded to include several children in this classroom or one child in each of several classrooms. The selection of the first classroom is critical. The SLP might begin with a best friend on the faculty, someone willing to learn, grow, and make mistakes (Moore-Brown, 1991). Teacher training should include SLP critiques of teacher use of training techniques. A checklist can ensure objectivity. It might be best for teachers to begin by attempting to integrate a child’s newly acquired skills into the daily routine, rather than trying to teach new language skills (Dyer et al., 1991). The first class taught by the SLP should, likewise, begin cautiously. One goal per lesson is recommended (Ferguson, 1992a). Later, individual IEP goals can be introduced through focused lessons with the whole class. Undoubtedly, there will be problems in initiating classroom intervention. The SLP is advised to choose the initial child and classroom carefully to ensure some measure of success and to minimize friction with the classroom teacher. Once the SLP and the teacher begin to experience success, other teachers will be more willing to adopt the model. There will always be administrators, classroom teachers, and/or parents who refuse to accept or cooperate with the implementation of the classroom model. Rather than become discouraged, the SLP should work with those individuals who accept the model and continue to try to educate those who do not. Usually, success with a few children is all that is needed to convince the foot-draggers. The key to success is “establishing a good rapport among the people involved” (Borsch & Oaks, 1992, p. 368).

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Conclusion Functional environmental approaches, as represented by the classroom model, are among the most progressive trends evidenced today. In many school districts throughout Canada and the United States, this model is a reality. Some districts are mandating the change from above, whereas others are experiencing a quiet revolution from below. No change as radical as this one can be accomplished without some difficulties. The role of the SLP is changing. In many cases, SLPs are being asked to implement intervention models for which they have minimal training. Although such requests are expected in a professional field that is changing and growing as rapidly as speech-language pathology, it does highlight the need for continuing professional education. Still, the SLP is the language expert responsible for identifying children with LI and for implementing intervention. In this new role of consultant, the SLP enhances this intervention process through others. By itself, going into the classroom is only the most minimal of changes. In fact, data indicate that many SLPs engaged in a collaborative model are now modifying their intervention style to a more functional one (Roberts, Prizant, & McWilliam, 1995). Although location, such as a classroom, was one of the variables of generalization addressed in the first chapter, it was not the only one. Functional intervention is conversational intervention. A truly functional approach uses language scaffolding techniques within real conversational contexts to accomplish communication goals.

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O

ne of the political forces in the current educational climate is the 2001 federal legislation known as No Child Left Behind (NCLB) that requires school-based professionals to adopt scientifically based research into reading intervention. SLPs working in schools are called upon demonstrate improved student performance through data-based outcomes. Like other professionals, school-based SLPs are expected to consult scientific evidence on intervention efficacy prior to determining the course of therapy. This process is called evidence-based practice (EBP), which was discussed in the first chapter. Within the heightened concern for reading achievement, school-based SLPs have increased responsibilities. Policies derived from NCLB require schools to implement preventive interventions, to identify children with reading disorders, and to implement reading interventions with these children. Schools are tasked with the responsibility to teach reading and also to monitor progress and identify for intervention those children who fail to achieve proficiency. SLPs can serve a valuable consultative and collaborative role. SLPs should be involved at the preschool and early elementary school level in preventive intervention for literacy. With older children and adults, SLPs are concerned with improving reading and writing skills. Recognizing a need, the American Speech-Language-Hearing Association (ASHA, 2001) recommended that SLPs play a role in the promotion of literacy. In short, children with LI are unprepared for literacy instruction because of a lack of preliteracy skills. Key indicators of this lack of skills can be found in their oral language and narrative ability, phonological awareness, alphabet knowledge, phoneme-grapheme (sound-letter) knowledge, spelling and orthographic knowledge, and word awareness (Justice, Invernizzi, & Meier, 2002). All these areas, plus literacy motivation and home literacy, should be assessed prior to formal reading instruction. Within a preschool or kindergarten setting, an SLP should (1) alert parents to the oral languageliteracy relationship, (2) identify children at risk and notify parents, (3) refer parents to good literacy programs, and (4) recommend assessment and treatment in preliteracy skills, such as phonological awareness, letter knowledge, and literacy activities, when needed (Snow, Scarborough, & Burns, 1999). Within the school-age population, the SLP (1) continues to help children or adolescents develop a strong language base; (2) addresses difficulties in phonological awareness, memory, and retrieval; and (3) addresses difficulties individual children are encountering with both narrative and expository or curricular texts. Children with LI are at a high risk for literacy disabilities (Lewis, O’Donnell, Freebairn, & Taylor, 1998). In one study, as high as 60 percent of children designated as having primarily language impairment experienced reading difficulties (Wiig, Zureich, & Chan, 2000). As preschoolers and kindergartners, children with LI are less able to recognize and copy letters and less likely to pretend to read or write, to engage in daily preliteracy activities, or to engage adults in question-answer activities during reading and writing than their typically developing peers (Marvin & Wright, 1997). As we progress through this chapter, I shall address all the topics mentioned so far. For clarity, I have divided the chapter into two major sections, reading and writing. Within each, I have organized the information into sections on problems for children with LI, assessment, and intervention. I have tried to be judicious and not include regular reading and writing instruction, subjects more appropriately taught by classroom teachers and reading specialists. Throughout this text, I have tried to take a top-down intervention approach. A similar strategy can be used in intervention with reading and writing. Obviously, some minimal phonics skills as well as phoneme-grapheme (sound-letter) knowledge are needed. Within guided reading practice, students can confront unknown words or grammatical structures and attempt to decipher the meaning from

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the surrounding text. They can be helped to read actively and to ask themselves questions about what they know, to summarize, predict, and interpret as they go.

Reading For the skilled reader, printed words are represented only briefly, both orthographically through printed letters and phonologically, for processing. Automatic and below the level of consciousness most of the time, each word is represented for less than one-fourth of a second while the brain retrieves all information about that word. The process only becomes conscious when the reader tries to interpret an unfamiliar word based on the context. Reading ability is highly correlated with spelling ability (Bosman & van Orden, 1997; Greenberg, Ehri, & Perin, 1997; Griffith, 1991). Poor readers tend to be poor spellers (Treiman, 1997). Instruction and advances in one area help the other (Ehri & Wilce, 1987; Uhry & Shepherd, 1993). Reading affects the memory for spelling, which in turn aids reading decoding. At another level of processing, language and world knowledge are used to derive an understanding of the text, much as one comprehends a spoken message. This comprehension process and the message being decoded are monitored automatically to ensure that the synthesized information makes sense (Snow et al., 1999). When something goes wrong in the reading process, it becomes less automatic and less fluent. Word decoding or understanding of language relationships expressed in the text may be impaired. Poor vocabulary may hinder understanding. Reading becomes labored and slow. The entire process may not make sense to some children, who may become frustrated and helpless. R EADI NG PROB LE MS Good readers guide and control their behavior. It’s purposeful and flexible (R. Anderson, Hiebert, Scott, & Wilkenson, 1985; Baker & Brown, 1984; A. Brown & Palinscar, 1982). In contrast, poor readers lack such strategies, reflecting their misconceptions of the task and their acceptance of failure (P. Johnston & Winograd, 1985; Torgeson, 1980). When children experience repeated reading failure, they become frustrated. They internalize their lack of success. Many children who read poorly become passive, lacking persistence and accepting low self-esteem, and display apathy and resignation (Butkowsky & Willows, 1980). Others will become aggressive or display acting-out behaviors. These affective problems interfere with subsequent learning and development (Winograd & Niquette, 1988). Risk of difficulty with reading is greatest among children with a history of problems in both articulation and receptive and expressive language (Segebart DeThorne et al., 2006). In general, poor reading comprehenders have deficits in oral language comprehension but normal phonological abilities. On the other hand, children who are poor decoders have poor phonological abilities but little or no oral language comprehension difficulties (Catts, Adlof, & Ellis Weismer, 2006). Children with LI who have average or above-average intelligence may read initially by memorizing word shapes. However, without word attack or decoding skills, by second grade these children begin to fail. Serious reading comprehension problems may go unnoticed among beginning readers who have good phonological ability and appear to decode words well (Nation, Clarke, Marshall, & Durand, 2004). Although isolated speech problems, such as a /w/ for /r/ substitution, do not seem to affect literacy learning, children with both speech and language difficulties, especially those who lack phoneme

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awareness at age 6, are at greater risk for literacy difficulties (Nathan, Stackhouse, Goulandris, & Snowling, 2004). Preschool language ability is a unique predictor of phoneme awareness in kindergarten, which together with early literacy skills predicts later literacy skills. Although children with LI in kindergarten are at greater risk for reading impairment, those whose spoken language abilities improve have better reading outcomes than those whose LI persists (Catts, Fey, Tomblin, & Zhang, 2002). As adolescents, poor readers also exhibit vocabulary, grammar, and verbal memory deficits in comparison with their TD peers (Rescorla, 2005). Children with LI are at risk for reading impairment for several reasons (Hambly & Riddle, 2002; C. Miller et al., 2001; Stanovich, 1986): begin with less language ability and have difficulty catching up. • They They have poor comprehension skills. • Metalinguistic skills are not developing because of poor overall language skills. • They have slower linguistic and overall information processing skills. • Most reading problems are related to deficient phonological processing (Catts & Kamhi, 1999). Even the errors of children with dyslexia are not aberrations and reflect the conventional English phonological system, as do the errors of younger children (Treiman, 1997). Consonant clusters are especially difficult for children with reading impairment and beginning readers. Children with SLI exhibit more graphophonemic (letter-sound), syntactic, semantic, and pragmatic miscues when reading than other children their age. Comprehension difficulties are revealed in less complete and more confused retellings of what they’ve read (Gillam & Carlile, 1997). Deficits in Phonological Awareness By age 4, children are beginning to attend to the internal structure of words such as phonological similarities and syllable structure. This is called phonological awareness. Four-year-olds also appreciate both sounds and rhymes. Phonological awareness is knowledge of the sounds and the sound structure of words and as such is part of metalinguistics. Among both children developing typically and those with LI, better phonological awareness and better reading skills are related (Cupples & Iacono, 2000). Phonological awareness skills also are the best predictor of spelling ability in elementary school (Nation & Hulme, 1997). Not a unitary entity, phonological awareness consists of many skills, including syllabication and phoneme knowledge, alliteration, and rhyming. Being able to create a word when a phoneme is deleted and to compare initial phonemes for likeness and difference are two areas of phonological awareness that are particularly important for the development of reading (Stanovich, Cunningham, & Cramer, 1984; Yopp, 1998). In new word creation following phoneme deletion, the child is asked a question similar to the following: If we take the /s/ sound out of sat, what word do we have left? As this example illustrates, there is clearly a correlation between phonological awareness and verbal working memory (Webster, Plante, & Couvillion, 1997). Phonological awareness is fundamental to reading readiness (Bradley & Bryant, 1985; Liberman & Shankweiler, 1985; Snyder & Downey, 1997; Wagner & Torgeson, 1987). Although phonological awareness skills in kindergarten predict subsequent reading performance, by second grade, word read-

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ing and phonological awareness are so correlated that phonological awareness skills alone have little influence on later reading (Hogan, Catts, & Little, 2005). Many children with phonological problems also have difficulty reading (Liberman, 1983; Swank, 1994; Torgeson, 1985). Children with expressive phonological delays have poorer phonemic perception and poorer phonological awareness skills than their TD peers (Rvachew, Ohberg, Grawburg, & Heyding, 2003). Difficulties seem to be related to failure to analyze words into syllables and these, in turn, into smaller phonological units (Bird, Bishop, & Freeman, 1995). Deficits in Comprehension In first grade, children are introduced to reading instruction and to the sound–letter correspondence called phonics. Words read by the child are linked with stored meaning for interpretation. Much of the child’s cognitive capacity is used in decoding, leaving little for higher language functions. When a child has poor word attack skills or poor phonics, he or she may read slowly. Large amounts of cognitive capacity are employed in this process, and the resultant slow reading speed taxes working memory. Although the result is poor comprehension, the underlying mechanism is totally different from that of a child who can sound out words but does not comprehend what is on the page. Deficits in comprehension may not be evident in the early stages of reading acquisition when phonics is extremely important. For example, although nearly 80 percent of poor readers with comprehension deficits in fourth and eighth grades had the same problem in second grade, only half were classified as poor readers, primarily because of the emphasis on phonics (Catts, Hogan, & Adlof, 2005). Although phonics-based problems often decrease by third grade, comprehension problems persist for many children (Foster & Miller, 2007). Among children as diverse as those with “generic” reading impairments, those with ASD, and those with SLI, poor reading comprehension is associated not with phonics but with poor oral language (Nation & Frazier Norbury, 2005). The situation compounds itself as children mature (Stanovich, 2000). Students with poor reading comprehension are likely to read simpler texts, often below grade level, and to read less frequently. This lack of exposure to print containing more mature structure and content results in poor readers becoming poorer as they fall farther behind their TD peers. CH I LDR E N WITH CLD BACKG ROU N DS For many children from CLD backgrounds, especially those from impoverished home environments, school and family cultural notions of the value of literacy may differ greatly. This mismatch potentially places a child at risk of poor literacy development, especially if he or she is experiencing oral language difficulties with English. Kindergarten English vocabulary, phonological awareness, letter-word identification, and Spanish word-reading skills are significant predictors of English reading skills by first grade (Páez & Rinaldi, 2006). Although TD bilingual children from low-income backgrounds initially perform poorly in all three areas, they acquire these abilities quickly in kindergarten (Hammer & Miccio, 2006). Although oral language skills in L2 (English in this case) are a predictor of reading in L2, oral language skills in L1 are not (August, Snow, Carlo, Proctor, Rolla de San Francisco, et al., 2006). Rather, reading skills in L1 are closely related to future ability in L2. More specifically, children with high Spanish letter-name and sound knowledge tend to also show high levels of both in English (CárdenasHagan, Carlson, & Pollard-Durodola, 2007). This may not be true for children with different first

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languages, especially those with different alphabets (Cyrillic, Arabic) or sound systems. Phonological awareness skills seem to transfer directly from Spanish to English. The good news is that all these skills—letter-name, sound knowledge, and phonological awareness—can be taught to these children easily.

ASSESSM E NT OF R EADI NG Language deficits associated with reading are often present during the preschool years. Prereading and reading assessment should be a portion of any thorough language evaluation. Data Collection Just as all children do not require an oral language assessment, neither do they all require a reading assessment. As mentioned in Chapter 3, language assessments begin with an initial data-gathering step that may include use of questionnaires, interviews, referrals, and screening testing. Table 13.1 presents a checklist designed to identify kindergarten and first-grade school children at risk for language-based reading difficulties (Catts, 1997). No one item alone will indicate a possible problem. On an early literacy parent questionnaire, parental reports of early literacy skills of their preschool children with LI compare favorably with professional assessments (Boudreau, 2005). Questions concerned the frequency of book-reading behaviors, responses to print, language awareness, interest in letters, and early writing. Early literacy can be screened using SLP-designed tasks such as those presented in Table 13.2 on page 383 (Justice, Invernizzi, et al., 2002). For a wider view, data from these tasks can be combined with parental information on home literacy materials and activities. Children who read poorly may exhibit learned helplessness or have negative attitudes toward the reading process. This information can be gathered from interviews with teachers, parents, and the child and by observation within the classroom. Interview questions should include the child’s perceptions of the importance of reading and different types of reading and difficulties, along with self-perceptions (Wixson et al., 1984). Scaled responses, such as a 0–5 disagree-agree scale, can be used with statements such as “Reading is difficult for me” or “My teacher helps me learn to read better.” Observation can confirm the child, teacher, and parent responses. Behavioral changes related to learned helplessness, such as nervousness, withdrawal, and aggression, can be noted. Lack of task persistence can be recorded as the amount of time or the number of attempts made in decoding a word or longer unit (P. Johnston & Winograd, 1985). A very high or very low number of requests for assistance also can be a good indicator. In addition, self-verbalizations blaming himself or herself (“I’m so dumb”) or others (“This story is stupid” or “Why didn’t you tell me I was next?”) rather than stating alternative strategies for success (“Oh, this word is spelled like _____, so it’s pronounced ‘_____’”) also may signal helplessness. During more formal testing, either the SLP or the reading specialist might use one of the following standardized testing to determine if the child is functioning within normal limits: of Early Reading Ability (Reid, Hresko, & Hammill, 2001) • Test Gray Oral Reading Test (Wiederholt & Bryant, 2001) • Woodcock Reading Mastery Test–Revised (Woodcock, 1998) •

Chapter 13

TABLE 13.1

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381

Early Identification of Language-Based Reading Disabilities: A Checklist

Child’s Name: ______________________________________________

Birthday: ________________

Date Completed: ____________________________________________

Age: ___________________

This checklist is designed to identify children who are at risk for language-based reading disabilities. It is intended for use with children at the end of kindergarten or beginning of first grade. Each of the descriptors listed below should be carefully considered and those that characterize the child’s behavior/history should be checked. A child receiving a large number of checks should be referred for a more in-depth evaluation. Speech Sound Awareness

▫ ▫ ▫ ▫ ▫

doesn’t understand and enjoy rhymes doesn’t easily recognize that words may begin with the same sound has difficulty counting the syllables in spoken words has problem clapping hands or tapping feet in rhythm with songs and/or rhymes demonstrates problems learning sound-letter correspondences

Word Retrieval

▫ ▫ ▫ ▫ ▫

has difficulty retrieving a specific word (e.g., calls a sheep a “goat” or says “you know, a woolly animal”) shows poor memory for classmates’ names speech is hesitant, filled with pauses or vocalizations (e.g., “um,” “you know”) frequently uses words lacking specificity (e.g., “stuff,” “thing,” “what you call it”) has a problem remembering/retrieving verbal sequences (e.g., days of the week, alphabet)

Verbal Memory

▫ ▫ ▫ ▫

has difficulty remembering instructions or directions shows problems learning names of people or places has difficulty remembering the words to songs or poems has problems learning a second language

Speech Production/Perception

▫ ▫ ▫ ▫ ▫ ▫

has problems saying common words with difficult sound patterns (e.g., animal, cinnamon, specific) mishears and subsequently mispronounces words or names confuses a similar-sounding word with another word (e.g., “The Entire State Building is in New York”) combines sound patterns of similar words (e.g., saying “escavator” for escalator) shows frequent slips of the tongue (e.g., saying “brue blush” for blue brush) has difficulty with tongue twisters (e.g., she sells seashells)

Comprehension

▫ ▫ ▫ ▫

only responds to part of a multiple-element request or instruction requests multiple repetitions of instruction/directions with little improvement in comprehension relies too much on context to understand what is said has difficulty understanding questions (Continued)

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TABLE 13.1

(Continued) Early Identification of Language-Based Reading Disabilities: A Checklist

▫ fails to understand age-appropriate stories ▫ has difficulty making inferences, predicting outcomes, drawing conclusions ▫ lacks understanding of spatial terms such as left/right, front/back Expressive Language

▫ ▫ ▫ ▫ ▫ ▫ ▫

talks in short sentences makes errors in grammar (e.g., “he goed to the store” or “me want that”) lacks variety in vocabulary (e.g., uses “good” to mean happy, kind, polite) has difficulty giving directions or explanations (e.g., may show multiple revisions or dead ends) relates stories or events in a disorganized or incomplete manner may have much to say, but provides little specific detail has difficulty with the rules of conversation, such as turn taking, staying on topic, indicating when he/she does not understand

Other Important Factors

▫ ▫ ▫ ▫ ▫

has a prior history of problems in language comprehension and/or production has a family history of spoken or written language problems has limited exposure to literacy in the home lacks interest in books and shared reading activities does not engage readily in pretend play

Comments

Source: Reprinted with permission from The early identification of language-based reading disabilities by H. W. Catts. Language, Speech, and Hearing Services in Schools, 28, 86–89. Copyright © 1997 by American Speech-LanguageHearing Association. All rights reserved.

The Test of Early Reading is designed for children ages 3 to 8 and assesses alphabet knowledge, phonological awareness, and ability to derive meaning from parts. A timed instrument, the Gray Oral Reading Test, is useful with slow readers. Finally, the Woodcock Reading Mastery Test assesses sight vocabulary, nonsense-word decoding, and comprehension. In a more functional task, a child might also be asked to read curricular materials in an attempt to assess her or his ability to function within the classroom (N. Nelson & Van Meter, 2002). The material should be new to the child to ensure that it has not been previously taught. Reading aloud gives the SLP information on decoding and can be audiotaped for later analysis. If curricular materials seem to be too difficult, the SLP or reading specialist could use graded passages, such as those found in the Qualitative Reading Inventory–III (Leslie & Caldwell, 2000). Regardless of the method of collection, some portion should be read aloud and audiotaped. Comprehension can be assessed by using questions. Alternative forms include retelling or paraphrasing. Most standardized tests include a comprehension subtest.

Chapter 13

TABLE 13.2

Literacy Impairments: Language in a Visual Mode

383

Clinician-Designed Tasks of Early Literacy Screening

Areas

Tasks

Print Awareness

During shared book experience, differentiates written-language units, such as letter, word, and sentence, and identifies direction of print flow, location of cover, functions of books, etc. (Clay, 1979; Justice & Ezell, 2000; Lomax & McGee, 1987)

Phonological Awareness

Reads common environmental words (Gillam & Johnston, 1985) Finds one in three words that differs on the basis of an onset or rime or tells how two words differ on the same basis (Maclean, Bryant, & Bradley, 1987) Produces words that begin with a certain sound or rhyme (Chaney, 1992) Produces a “new” word after one sound has been deleted, as in “Say cat without the /k/ sound.” (Lonigan, Burgess, Anthony, & Barker, 1998) Takes a word apart, then puts it together again

Letter Name Knowledge

Grapheme-phoneme Correspondence Literacy motivation

Home literacy

Identifies the number of phonemes in a word Says the names of upper- and lowercase letters or points to letters named in two modes, at own pace or as fast as possible (RAN) (Blachman, 1984; Justice & Ezell, 2000) Produces sound that goes with letter or names the letter that goes with a sound (Juel, 1988). Could also be accomplished with pointing to letter when sound is heard Engages in a variety of literacy events and level of involvement is rated along a continuum from no engagement to high engagement (Kaderavek & Sulzby, 1998) Parents complete checklist or questionnaire on home literacy activities and materials to determine child’s access and participation (Allen & Mason, 1989; Dickinson & DeTemple, 1998)

Source: Adapted from Justice, Invernizzi, & Meier (2002). Readers are advised to read this article for a fuller explanation of the tasks mentioned.

Data Analysis Passages should be photocopied and used by the SLP to record discrepancies noted on the audiotaped reading samples. All attempts at word decoding, repetitions, corrections, omitted words and morphemes, extended pauses, and dialectal usages should be noted by the SLP and analyzed for possible strategies used by the child. There is little danger that children with SLI or LLD will inflate their performance by guessing words correctly, because a part of their reading difficulty is an inability to integrate syntactic, semantic, and textual information (N. Nelson & Van Meter, 2002). The percentage of words correct on the first attempt should be calculated. Usually, children who experience less than 90 percent correct on their first attempt demonstrate frustration (Leslie & Caldwell, 2000). Miscues can be analyzed by type at the word level (N. Nelson, 1994). These include reversals, in which word order is changed; semantic substitutions, in which an acceptable but different word is

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substituted; syntactic substitutions, in which a syntactically appropriate but semantically nonsensical word is substituted; insertions, in which a word is added; and deletions. The percentage of incorrect but linguistically acceptable words should be calculated as these indicate the use of linguistic cues to predict the correct word. The SLP should note the way in which the child sounds out the words (N. Nelson & Van Meter, 2002). Good readers use several strategies. Common strategies include the following: by sound • Sound By consonant including digraphs (“sh,” “th,” “on,” “ch,” “ay”) • Common rimesclusters (“-ack,” “-ite,” “-at”) • Morphemes (“un-,” “dis-,”“-ent,” “-ly”) • Assessment of Phonological Awareness Phonological awareness is multifaceted and assessment should mirror this fact. In addition, an assessment for phonological awareness should be accomplished within an overall assessment of reading that includes measurement of reading, spelling, phonological awareness, verbal working memory, and rapid automatized naming (RAN). One caution: African American children from low-income families may score below expected norms on some phonological awareness measures, such as the Test of Phonological Awareness (Torgesen & Bryant, 1994), even though their reading performance is within normal limits (Thomas-Tate, Washington, & Edwards, 2004). A thorough assessment of phonological awareness includes rhyming, sound isolation, segmentation, blending, deletion, and substitution. The rhyming portion is only predictive of reading with preschool and kindergarten children. Formal testing can be accomplished using the Comprehensive Test of Phonological Processing (CTOPP) (Wagner, Torgesen, & Rashotte, 1999) or the Phonological Awareness Test (PAT) (Robertson & Salter, 1997). Designed for ages 5 through 21, the CTOPP includes subtests on deletion of sounds, sound and word blending, segmentation, and phoneme reversal, a difficult memory task. In addition, tasks on the CTOPP also assess verbal working memory and RAN. The PAT, designed for children ages 5 through 9, includes testing of rhyming, segmentation, phoneme isolation, deletion, substitution, blending, sound-symbol association, and word decoding. Assessment of Comprehension Assessment for comprehension is difficult because of the multifaceted character of the process. Kindergarten and first-grade screening tests focus on phonological awareness and phonics, thus identifying only children who will have difficulty with early reading. Comprehension deficits manifest themselves later and are not based on an inability to sound out words. Likewise, a single silent reading comprehension test is insufficient to identify those who are slow readers from those who have language-based comprehension problems (Snyder, Caccamise, & Wise, 2005). At the very least, a thorough evaluation must include the following: language skills, especially vocabulary and listening comprehension • Oral Narrative skills from conversational samples •

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assessment of all aspects of comprehension beyond simple recall of text content, • Standardized including paraphrasing, summarizing, predicting, and inferencing • Sampling of grade-appropriate reading comprehension I NTE RVE NTION FOR R EADI NG I M PAI R M E NT While many skills, such as scribbling, develop along with or in correlation with reading, these skills are not necessarily precursors to reading. An SLP must consult the research literature to decide on intervention targets and methods that will be most efficacious. Evidence-based practice (EBP) suggests that four possible preschool target areas are strongly related to later reading development: alphabet knowledge, print and word knowledge, phonological awareness, and literate language (Justice & Kaderavek, 2004). Alphabet knowledge consists of knowing the features and names of letters in both upper- and lowercase. This differs from print and word knowledge, which is knowledge of how letters form words and the ways that pages (left to right) and books (front to back) are organized. Phonological awareness, as mentioned before, involves awareness of the sound and syllable structure of oral language. Finally, literate language differs from oral language in its use of vocabulary and syntax, such as elaborated noun phrases, to create text. These written conventions differ from those used in speech. Although primary responsibility for prereading instruction falls upon the classroom teacher, the SLP has expertise in some areas in which teachers are unprepared. Despite programs such as Head Start, a need for intense exposure to literacy in preschool continues to exist, especially for children from CLD backgrounds (Hammer, Miccio, & Wagstaff, 2003). Given that African American preschoolers with more complex syntax and shape-matching skills have better reading skills by third grade, it would be wise to target these areas for instruction (Craig, Connor, & Washington, 2003). For preschool and kindergarten children with LI, the transition from prereaders to readers can be facilitated by an integrated multitiered intervention approach using both embedded and explicit approaches and targeting the four areas of (1) alphabet knowledge, (2) print and word knowledge, (3) phonological awareness, and (4) literate language, mentioned previously (Justice & Kaderavek, 2004). Children demonstrate widespread gains in a number of emerging literacy skills when both explicit and implicit methods are used (Justice, Chow, Capellini, Flanigan, & Colton, 2003). In embedded approaches, children’s growth is fostered through high-quality daily literacy experiences and interactions with print that are placed within meaningful literacy activities. The goal is to maximize children’s use of print through a literacy-rich environment (Towey, Whitcomb, & Bray, 2004). Other elements may include the following: message board with words to count and segment and sounds to blend into words, or for • Morning finding words that begin with a selected sound or rhyme breakfast and lunch menus with printed words and pictures • In-school Matching games throughout the day using sounds and rhyming • Recipes with and pictures • Music, fingerwords play, and rhyming • Identifying beginning sounds themed activities, such as the names of different kinds of • trucks, e.g., F-iretruck, M-ixer,within D-umptruck, etc. • Sorting tasks by rhyming

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Embedding might include labels on items in the classroom, increased availability of children’s books, and shared story reading with adults. These approaches may be more effective than more explicit models in increasing children’s positive orientation to reading. Individual book sharing accompanied by targeted questions can improve both literal and inferential language skills among Head Start preschoolers with LI (van Kleeck, Vander Woude, & Hammett, 2006). Examples of questions and prompts for correct answers are presented in Table 13.3. Book sharing accompanied by dialogue is an excellent activity for promoting oral language, including syntax, semantics, and language comprehension (van Kleeck, 2003). Sustained and intensive preschool, kindergarten, and first- and second-grade intervention can reduce reading difficulties among at-risk children (Justice, 2006). As little as a 15- to 20-minute daily block of dedicated literacy time in preschool may be sufficient to forestall reading difficulties for many children (Kame’enui, Simmons, & Coyne, 2000). This increases to 30 to 45 minutes in kindergarten and 90 minutes by first grade. In contrast, explicit approaches include direct instruction of discrete skills. Some skill areas, such as phonological awareness, may be best suited to an explicit approach. Ideally, explicit instruction would be provided in the classroom, in small groups, and individually. The classroom teacher is primarily responsible for embedded learning and for explicit whole-class instruction. Through collaboration, intervention team membership, and classroom activities, the SLP can support the classroom teacher while fostering children’s growth in literacy. By age 3, most children in our culture are familiar with books, can recognize their favorite books, and have the rudiments of print awareness, such as knowing the direction in which reading proceeds across a page and through a book, being interested in print, and recognizing some letters (Snow et al., 1999). Print awareness includes these skills plus later-developing ones, such as knowing that words are discrete units, being able to identify letters, and using literacy terminology, such as letter, word, and sentence. Print awareness can be increased among preschool children with print-focused reading activities (Justice & Ezell, 2002). In contrast to picture-focus strategies that stress characters and actions found in the pictures accompanying the story, print-focus strategies emphasize word concepts and alphabetic knowledge. Print- and picture-focus prompts are presented in Table 13.4 on page 388. In general, preschool children respond more to print-focused prompts than to print-focused comments by adults (Justice, Weber, Ezell, & Bakeman, 2002). Parents can be taught to use print-based reading strategies that enhance their children’s printreferenced behaviors (Justice & Ezell, 2000). Print-focused prompts are easy to teach, and parents have been successful with only minimal training. For example, a parent can easily point to words as she or he reads to a child. As a result, the child learns about print through the behavior of the parent. Print referencing has been shown to facilitate development of word concepts and alphabet knowledge as well as print concepts (Ezell, Justice, & Parsons, 2000; Justice & Ezell, 2002) For emergent readers who fail to achieve adequate reading, intervention is different from that addressed with prereaders and includes phonemic awareness, phonics, fluency, vocabulary, and reading comprehension. As in prereading difficulties, some of these areas are best addressed by an SLP. Reading intervention might begin with a two-stage intervention model (van Kleeck, 1995). In stage one, meaning foundation, the reader scaffolds the reading for a child by placing the text in context and asking questions to guide comprehension, much as a SLP books shares with preschool children as explained in Chapter 12. The child learns that print contains the meaning and gains

Chapter 13

TABLE 13.3

Literacy Impairments: Language in a Visual Mode

387

Literal and Inferential Questions and Prompts for Use in Guided Reading

Question

Feedback/Prompt

Level I (Literal) What’s that?

Correct: Repeat correct answer and “Yes, it’s a X.” Incorrect: Build a bridge to the correct answer. “Yes, it’s a kind of Y called a. . . ” No response: Prompt with the beginning sound or syllable, and if still no answer, tell the child and provide more information.

Level II (Literal) What’s the bunny doing?

Correct: Repeat correct answer and “Yes, he’s X-ing (running, jumping, Incorrect: Build a bridge to the correct answer. “Yes, that’s the bunny and he’s . . . ” No response: Prompt with the beginning sound or syllable, and if still no answer, tell the child and provide more information.

Level III (Inferential)

Correct: Repeat correct answer and “Yes, I think he feels X because Y. Do you ever feel X?

How do you think the Incorrect: “I think he feels X because . . . ” After child gives reason add “Yes, bunny feels when he finds the bunny feels X because (repeat child’s reason).” all his friends are hiding? No response: “Bunny feels . . . ” If no response, “Bunny feels X because Y. Do you ever feel X?” Level IV (Inferential) What do you think the bunny will do next to find his friends?

Correct: “I think so too. The bunny wants to X so he can Z. Shall we keep reading and see?” Incorrect: “I think he’s going to do X so he can . . . ” After correct response, “Yes, I think so, too. He’s going to X so he can Y.” No response: “Bunny wants to Y, so he’s going to X.”

Source: Adapted from van Kleeck, Vander Woude, & Hammett (2006).

phonological awareness and letter knowledge. In stage two, form foundation, phonological awareness and alphabetic knowledge are emphasized. Phonological training would include syllables and subsyllabic units, such as initial phonemes, or onsets, and rimes, or the remaining part of the word. Rhyming and alliteration activities also would be used. Training in alphabetic knowledge would include learning uppercase letters, followed by lowercase, copying shapes and letters, sound-letter correspondence, and knowledge of meaning found in books read to the child by others. Four levels of abstraction of meaning are presented in Table 13.5 on page 389. The first two require concrete skills, such as naming and describing, while the latter two require children to make inferences and to reason. Instruction with second graders in both explicit word recognition (letter and sound correspondences) and reading comprehension results in significantly better phonological decoding than instruction in either method individually (Berninger, Vermeulen, Abbott, McCutchen, Cotton, et al., 2003).

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TABLE 13.4

Print-Focus and Picture-Focus Prompts

Strategies

Examples

Print-Focus Strategies

Nonverbal Verbal Print Conventions

Point to print in text or to print in illustrations Follow print with finger while reading Ask questions:

Request:

Do you read this way or this way? And this one says? Where would you read if you were telling this story? We start here and turn the pages this way. That one tells you what the boy says. Show me how to hold a book to read. Can you show me where it says “Help”? Where is the last word on the page? Is “cat” a word? This word says “cow.” This says “hungry” and this says “caterpillar.” We put them together to make “hungry caterpillar.” Show me the first word. You point to the words and I’ll read. Do you know this letter? What does it say? What’s the first letter in “bear”? That’s a B. It makes the /b/ sound. Where’s Spot? Bet we can find her. Spot begins with S, just like your name, Susan. Show me where the P is.

Ask questions: Comment: Requests: Ask questions: Comment: Requests: Ask questions: Comment: Requests:

Who’s this? That’s her dad. I wonder where the turtle is. What’s in the tree? This cow is white and black. Show me something that’s blue. Now what’s he doing? Now he’s running home. Show me how she waves.

Comment: Requests: Word Concepts

Ask questions: Comment:

Request: Alphabet knowledge

Asks questions: Comment:

Picture-Focus Strategies

Character focus

Perceptual focus

Action focus

Source: Adapted from Justice & Ezell (2002, 2004).

A promising comprehension model, employing reflective discussion by students, is CORE, or Connect, Organize, Reflect, and Extend, discussed in the following section (Calfee & Patrick, 1995). Phonological opacity—the transparent or opaque nature of morphological derivations—affects both reading speed and accuracy. In transparency relationships, a base word does not change when a morphological affix is added, as in active-activist. In opaque relationships, the base word changes, as

Chapter 13

TABLE 13.5

Literacy Impairments: Language in a Visual Mode

The Four Levels of Abstraction and the Strategies at Each Level

Level I: Matching Perception

Comments or questions that: Label: name an object or person

Locate: locate an object or character

Level II: Selection Analysis/Integration of Perception

Comments or questions that: Describe characteristics: focus on properties or parts of objects or personal quality of characters Describe scene: describe actions Skill practice: numbers, colors (letters go under print conventions)

Notice: direct attention to a pictured object but do not name

Recall information: focus on prior information presented in book during current reading Cloze: pause to allow child to complete sentence of text

Not tied to a level of abstraction: Print and book conventions Interaction

389

Talk about how books work (title, author, which way print goes, etc.) Manage behavior, provide feedback, ask for clarification, imitate child

Level III: Reorder/Infer About Perception

Level IV: Reasoning About Perception

Comments or questions that: Summarize (information in book): describe two or more actions or events in book Define (word meaning): Distinguish between fantasy and reality

Comments or questions that: Predict (what will happen next or outcome of story)

Provide point of view (for a character in the text)

Problem solve: consider causes of events, formulate solutions, explain obstacles to characters’ thinking or actions Explain (story concepts or actions)

Recall information: from previous reading of book Identify similarities and differences (between pictured objects or between story and child’s life) Make judgments (about characters, ideas, or objects) Unify pictures: summarize or synthesize information from a series of pictures in book

Source: van Kleeck, A. (1995). Emphasizing form and meaning separately in prereading and early reading instruction. Topics in Language Disorders, 16(1), 27–49. Reprinted with permission.

in piano-pianist. The more opaque the relationship, the more difficult the word is to read. An SLP can help older students by “morphing” words into parts and helping children to hear the sound changes while appreciating the spelling consistencies, as in sign-signature. A fun activity is “Comes From,” which employs underlying semantic relationships (Green, 2004). In this activity, the SLP poses questions such as “Does mother come from moth?”

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Later reading intervention might target both linguistic and metalinguistic skills including recognition of key words, use of all parts of the text such as the glossary and the index, and application of general learning strategies, such as graphic organizers (Wallach & Butler, 1995). Intervention for Phonological Awareness Luckily, phonological awareness can be taught to preschool, kindergarten, and elementary school children, so both prevention and remediation can be targeted (van Kleeck, Gillam, & McFadden, 1998). The goals of phonological awareness intervention are (Hambly & Riddle, 2002): help the child learn the English language sound code as a basis for phonics • To To • improve the child’s reading and writing With the accomplishment of these goals, not only does reading improve, but so do acting-out behaviors and feelings of helplessness. Intervention for phoneme awareness can be effective with preschool children, even those with speech impairments related to sound production (Gillon, 2005). Developmental intervention for phoneme awareness can include the following: and decoding print • Encoding awareness and identification • Phoneme • Letter identification In typically developing children, syllable and rhyme awareness appear to be skills acquired prior to phoneme awareness; however, targeting these skills may not benefit some children in later literacy acquisition (Nancollis, Lawrie, & Dodd, 2005). Phoneme awareness teaching activities can be placed within play activities and can include (Gillon, 2005) the following: detection (Find the word that starts with . . . Does . . . begin with . . . ?) • Phoneme Phoneme categorization all the toys that begin with . . . ) • Initial phoneme matching(Find (Ball with /b/. Find the one that begins the same as ball. Book. Doll.) • Phoneme isolation (What soundbegins does pony start with?) • Letter-name and letter-sound intervention can begin with recognition of letters that vary widely in their appearance and accompanying sound. Within words, it’s best to begin with the letter in the initial position. Picture cards should contain the word written under the picture, so children can begin to match sound and letter. Whenever possible, phonological awareness should be taught within meaningful text experiences (McFadden, 1998). In this way, the emergent nature of both literacy and phonological awareness can be used. Environmental signs, such as stop, women, and Main Street, should be used to enhance training. Within intervention, the SLP addresses segmentation and blending, working first at the syllable and then sound levels. In general, programs focusing on one or two phonological awareness skills yield better results than those that try to teach with a broader focus (National Reading Panel, 2000). The goal of phonological awareness intervention at the syllable level is to help children segment and blend syllables in order to read and spell multisyllabic words (Hambly & Riddle, 2002). Syllables

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can be introduced as naturally occurring “beats” in a word. Clapping hands or drumbeats can be used to help children recognize and identify syllables. Jaw movements in a mirror can also be helpful, especially if low, open-mouth vowels and elongated diphthongs are part of the syllables used. As stressed throughout this text, an SLP should teach skills that will directly impact a child’s functional performance. Syllable structure is important for phonemic training. The Wilson Word List (Wilson, 1996) is a good resource and is organized by syllables, sounds, and blends. Phonemic awareness, a high-order form of phonological awareness, is sensitivity to the sound structure of language at the phoneme level, including manipulation of sounds within words. Awareness intervention targeting phoneme segmentation, manipulation, and blending can be beneficial beyond the elementary grades and with bilingual children who read English poorly (Swanson, Hodson, & Schommer-Aikins, 2005). Intervention can begin with sound recognition and identification, first in the initial position in words. Training should be both receptive and expressive. Next, the SLP and child can move to syllable onset-rime segmentation and blending and finally, to phoneme segmentation and blending. Training can begin at the syllable onset-rime level (/tr-its/), then move to nucleus-coda (/i-ts/), and finally to onset-nucleus-coda (/tr-i-ts/). At the phoneme level, it seems best to work on sounds within single syllables since cross-syllable training has less effect on overall phonological awareness. Phoneme segmentation, or segmenting a word into sounds, is easier than blending, or creating a word from sounds, and intervention should begin with segmentation first. Begin with only two sounds and gradually increase to five or six. Real words are better than nonsense ones and will decrease the memory load for children, although the latter can be added as training progresses. The training should progress from CV and VC syllables to CVC to CCVC to CVCC. Final blends are the most difficult. It’s advisable to concentrate on one type of final blend at a time rather than mixing all possible ones together. Memory can also be aided with the use of real objects or pictures. Working at the word level results in more gains than using longer units, such as sentences. Printed letters can be used to support phoneme learning, especially if letters are used in the classroom. Again, a functional approach tries to incorporate use contexts, such as the classroom, as much as possible. Letters give additional input, are a potential memory aid, and are functional for generalization to reading. For children with deficits in working memory, letters can offer a compensatory visual aid. It is important for the SLP to remember that intervention is for phonological awareness not reading per se. It is very tempting to try to teach reading, but that is not the job of an SLP. Letter-sound knowledge can be viewed as consisting of recognition, or pointing to a letter or letters when a sound or consonant blend is presented; recall, or saying a sound or sounds when a letter or consonant blend is presented; and reproduction, or writing a letter or consonant blend when the sound or sounds are heard. In general, recognition is easier than recall, which in turn is easier than reproduction (Dodd & Carr, 2003). Multisensory approaches are also helpful and can make the training interesting. For example, during auditory training children can respond by dropping objects into cans, stacking toys, playing hopscotch, or taking turns in any number of child games. Although typically developing children seem to benefit more than children with SLI from computer-supported phonological awareness intervention, the method still holds promise as one aspect of a comprehensive intervention plan (Segers & Verhoeven, 2004). Vowels offer a particular problem because of the number and inconsistent spelling in English. An SLP can begin with short vowels because they are the nucleus of the longest syllables, called closed syllables. Closed syllables have rimes that end in at least one consonant and may have a maximum of six

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TABLE 13.6

Difficult Phoneme–Grapheme Relationships

Phoneme

Example

Explanation

/r/-controlled vowels diphthongs /e/ /L/

Through, true, crew Fly, height, right Sofa, telephone Fun, won, one

Inconsistent spelling Inconsistent spelling Stress and spelling interact Multiple spellings

Grapheme

Example

Explanation

-nk x u Plural -s Past -ed -pt

Thanks, rink Tax i, max imum tune, fun Dogs, cats, kisses Walked, jogged, collided Kept, slept

Two phonemes /ηk/ Two sounds /ks/ Two pronunciations /U/ and /L/ Multiple pronunciations Multiple pronunciations Final blend has short stop

Source: Adapted from Hambly & Riddle (2002).

phonemes in the word, as in scrimp. The rime is VC+ in form. Children can be taught common rimes such as -ent, -ide, -old, and -ick. Long vowels can be introduced later, first in the VCe form, in which the “e” is silent, as in home; followed by the open syllable with no consonant in the coda, as in tray or she. Appearing in short syllables or syllables with unusual spellings, long vowels can be taught as intervention assumes more of a reading focus. The inconsistent spelling of long vowels can be seen in day, weigh, and raise. Training of the phoneme–grapheme relationship should be approached cautiously following the outline above. Some sound–letter relationships, presented in Table 13.6, are particularly difficult. Intervention for Comprehension Traditional reading intervention emphasizes decoding. Feedback focuses on reading accuracy. Phonologically based intervention is somewhat confined, and intervention for comprehension should include semantics, syntax, morphology, and working memory skills as well. Although phonological awareness is important in the early stages of learning to read, morphological awareness of the structure of words has eclipsed phonological awareness in importance for comprehension by fourth grade (Carlisle, 1995, 2000; Katz, 2004). Comprehension relies on many different aspects of processing. When we read, our knowledge and experience blend with the information on the page to form a mental representation of the meaning (Kintsch, 1998). That’s comprehension. Because texts don’t spell out all semantic relationships, an active reader makes inferences from the text and past knowledge and experience that bridge these gaps. In semantic- or meaning-based intervention, a child creates meaning from the text at the word, sentence, and mental representation levels. This occurs as children mesh their own knowledge with the information on the page. An SLP or teacher attempts to facilitate this process through instruction, questions, visual and verbal cues, explanations and comments (Crowe, 2003). Through the use of con-

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textually supported feedback, such as establishing the content and setting the scene prior to reading, establishing relationships, and discussing unfamiliar vocabulary and concepts, an SLP or teacher assists students in constructing meaning from print. Using a conversational style, the adult provides cues and feedback as oral group reading occurs. It’s important that questions used by adults reflect the level of comprehension targeted and not simply ask all students to recount facts from the page. The semantic strategy should be accompanied by more direct vocabulary instruction, especially for words related to specific topics, such as ecology or geometry (Ehren, 2006). The effect of different adult strategies is dependent upon when they are used. For example, while semantic strategies prior to reading reduce reading miscues or errors, graphophonemic strategies are more effective during reading (Kouri, Selle, & Riley, 2006). Semantic strategies consist of giving a definition or synonym for key words. In contrast, graphophonemic strategies include encouraging a child to “sound out” a word, calling a child’s attention to phonetic regularities, or asking a child to identify initial or final sounds or consonant blends. Comprehension can be enhanced by inferential thinking that goes beyond the text and helps children integrate their world knowledge with the information on the page. CORE (Calfee & Patrick, 1995), mentioned in the previous section, uses dialogue between the teacher and students to help students construct meaning through a four-step process: Connect, Organize, Reflect, and Extend. The model is employed as children read, not just at the conclusion of the story. In the Connect step, the teacher provides background information or encourages students to use their own knowledge sources. For example, if reading the story of the boy who put his finger in the dike to prevent flooding, the teacher would discuss what a dike is and why it’s needed, especially in The Netherlands, where the story takes place. Given what we’ve discussed, it seems wise to use this step prior to reading. In the Organize step, students would summarize the story and/or select the main idea or ideas. The Reflect step asks students to contemplate alternatives, explain motives, and personalize the story. Finally, in the last step, Extend, students are asked to predict what will happen next in the story based on the information to this point. Ideally, students will internalize comprehension strategies and use them as they read actively. Three types of strategies are goal-specific strategies, monitoring and repair, and packaging (Ehren, 2005, 2006; Pressley, Borkowski, & Schneider, 1987). Goal-specifc strategies include the following: context to analyze word meaning • Using Activating prior knowledge • Rereading difficult • Self-questioning topassages help frame key ideas • Analyzing text structures • Visualizing content to determine type of reading • Paraphrasing in one’s own words • Summarizing • These strategies are used in tandem with the monitoring and repair strategies, in which a reader decides if a reading passage makes sense and, if not, what repairs need to be made so that it does. On the basis of these answers, a reader decides which of the goal-specific strategies to continue, discontinue, or modify. Finally, packaging strategies organize the entire process, planning what to do and how to do it through the other two types of strategies. It’s this active aspect of reading that truly constitutes self-regulated reading. Let’s take a look at the goal-specific strategies in more detail.

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When we analyze children’s eye movements while reading, we begin to understand that their eyes are bounding ahead and back, trying to check the accuracy of words within the surrounding meaning. Children are sense-makers, and when they read, they are trying to make sense of the words on the page. In similar fashion they can be taught to use this information to determine word meaning (Owens & Kim, 2007). They can also be helped to use dictionaries and glossaries, to analyze words into roots, and to use sentence structure to acquire word meaning. Although more important for expository reading than narrative reading, activation of prior knowledge can improve comprehension, especially for children with LD (Carr & Thompson, 1996; Dole, Brown, & Trathen, 1996). As a student reads, he or she gathers information that is kept current and used to interpret following passages. Once students can successfully access this knowledge, they can be helped to use it to predict subsequent information from the text. In addition, children can be helped in applying past learning and experience to the comprehension task. Good readers recognize when they have not comprehended a written passage and therefore reread it. Poor readers may not realize that they have missed key points. Several of the strategies presented here will help students with LI recognize what they don’t know. When this is highlighted for them, a teacher or SLP can guide them to reread portions of the text. Self-questioning is a strategy that encourages a reader to be active and to make inferences that the author hopefully intended the reader to make. Students should be encouraged to ask questions about the structure, such as when and where a narrative occurred, and about specific content, such as why a character acted a certain way. Text structure provides information that assists readers in determining overall organization and important points. Students can be instructed in the use of text structure to assist comprehension, modeling, and guided and independent practice, including “think alouds” to evaluate one’s progress (Dickson, Simmons, & Kame’enui, 1998). Explorations to be made by a reader include type of text, expository or narrative • The cues that aid in figuring out the organization, such as headings, introductory paragraphs, • Visual and topic sentences organization • Overall most important ideas • The • Devices that signal how ideas are connected Many of us, maybe including you, are visual learners. It helps us to see a picture or diagram. By helping children with LI visualize the content, written material, especially narration, comes alive. Imagery can be taught as a strategy for increasing comprehension. Paraphrasing and summarizing can occur at various points in reading, such as the end of a paragraph or a passage. Good readers do this automatically as they read. Paraphrasing demonstrates a child’s comprehension by forcing a child to focus on the meaning and to replace content words and/or syntactic structure with equivalent forms. In order to paraphrase and summarize, students with LI may need to be helped in identifying the main idea in what they read. Identifying the Main Idea Children with LI often cannot find the main idea or organizing frame even in simple texts. This task is fundamental to success in comprehension and academic success. The overall organizational abilities

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of some children may account for reading and writing problems. Incoming information needs to be organized for comprehension. Structure of narrative and expository texts differs greatly and affects comprehension and memory. Readers or listeners go through a process of deleting, generalizing, and integrating the propositions of a text until they reach a macrostructure that summarizes the propositions presented. This process is dependent on underlying cognitive classification skills and world knowledge. Text often is evaluated for its “goodness-of-fit” to the reader’s expectations. World or prior knowledge also provides organizational strategies for writing. Children vary in their ability to make use of prior knowledge (Pehrsson & Denner, 1985). Informational understanding develops as the readers progressively revise their expectations until they approximate the meaning of the author. Organizational clues supplied by the author enable the reader to interpret the passage and determine the main ideas. Several textual features signal important information, including graphic features, such as italics, boldface, and type size; syntactic features, such as word order; semantic features, such as summaries and introductions; and schematic features, such as text structure. Of course, it is easiest to determine the overall organization if the topic is stated explicitly in the first sentence. Good readers are sensitive to the text organization. They “discover” the organizing structure. In general, poor readers are less sensitive to important information. Many children with LI have difficulty comprehending and producing narratives because they fail to realize the internal organization of the text (Yoshinaga-Itano & Snyder, 1985). In general, these children fail to integrate new information with prior knowledge or fail to use the author’s clues (Pehrsson & Denner, 1988). Poor readers use a fragmented organization or impose an unrelated structure. Even though third and fourth graders are able to recall important information, they have difficulty deciding what information is important in a text. Intervention might include comprehension strategies, such as predicting, questioning, clarifying, and summarizing; semantic networking; generative tasks in which the child generates a summary sentence; and familiarization with different text structures (Armbuster, Anderson, & Ostertag, 1987; Richgels, McGee, Lomax, & Sheard, 1987; J. Williams, 1988). In general, by second grade, children are aware of strategies for summarizing text. Strategies used by older children include deletion of unimportant information, deletion of redundant information, substitution of category names for various category members, and selection or creation of a topic sentence. Direct instruction in these strategies results in the best performance (Rinehart, Stahl, & Erickson, 1986; J. Williams, 1986). Semantic networking or organizing is a method of teaching organization (Heimlich & Pittelman, 1986; Pehrsson & Denner, 1988; Pehrsson & Robinson, 1985; J. Williams, 1988). Helping children organize and reorganize structure during and after reading improves reading comprehension, writing cohesion, retention, and recall (Denner & Pehrsson, 1987; Reutzel, 1985; Schultz, 1986). Ideas are displayed in semantic networks as clusters resembling spiders. Major ideas are circles or other shapes. Lines form related ideas or connect major ideas. Semantic clusters can be taught with a guided study approach that helps the child develop generalizable strategies. Slowly, students adapt and internalize the methods for reading comprehension and for writing. Organizational patterns are of two types: cluster and episodic. Cluster patterns are for superordination and subordination. In Figure 13.1, the topic, or superordinate aspect, is in the center. Related ideas radiate outward. Episodic organizers representing change move from event to event as in narration. These also can be used for problem-solution and cause-effect diagrams.

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FIGURE 13.1

Examples of semantic networking.

Source: Adapted from Montgomery (1992a); Pehrsson & Denner (1988).

Children can begin to use semantic organizers in kindergarten or first grade, drawing pictures for the sequence of events in a narrative. Older children can write events in each cluster, either to aid recall or to structure narratives for telling or retelling. Variations, such as the story map, can help children develop story grammars (Figure 13.1). Similar diagrams, such as the mind map, can be adapted to various purposes, such as a book report, newspaper article, or argument (Montgomery, 1992a). Likewise, classroom brainstorming can help children realize their prior knowledge by examining all they know about a given topic (Dodge & Mallard, 1992). As SLPs, we are interested in language and in helping children make sense of the language they receive and produce. Semantic networking is just one method of doing this.

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Writing As with all language modes, writing is a social act. Just like a speaker, the writer must consider the audience. Because the audience is not present when the writing occurs, writing demands more cognitive resources for planning and execution than does speaking (Golder & Coirier, 1994; Graham & Harris, 1996, 1997; Scott, 1999). Writing and reading are not simply reverse processes. Rather than creating meaning from the written text and integrating it with background knowledge, the writer uses knowledge and new ideas to create text (Kintsch, 1998). Writing is a complex process that includes the generation of ideas, organization and planning, action based on the plan, revision, monitoring, and self-feedback (Scott, 1999). Writing is more abstract and decontextualized than conversation and requires internal knowledge of the writing form. Forms can be divided into narrative and expository writing. Expository texts have several forms. The easiest type, especially with familiar content, is sequential or procedurally organized, while others are descriptive with little overall structure. A typical sequential text explains how something is accomplished. Problem-solving, cause-and-effect, and compare-and-contrast genres are the most difficult. The writing system consists of several processes: text construction, handwriting, spelling, executive function, and memory (Berninger, 2000). Text construction is the process of going from ideas to written texts. This is not the same as actual handwriting and spelling, although all three are correlated. Texts consist of words and sentences supporting the ideas of the writer. Executive function is the self-regulatory aspect of writing. It’s the ability to select and sustain attention, organize perception, and flexibly shift perceptual and cognitive setup, as well as control social and affective behavior (Ylvisaker & DeBonis, 2000). Further, executive function includes realistic selfappraisal of strengths and weaknesses and the difficulty of tasks; the ability to set reasonable goals; planning and organizing to achieve each goal; initiating, monitoring, and evaluating your performance in relation to each goal; and revising plans and strategies based on feedback. Intelligence and executive function are not the same thing, although language use and executive function are interdependent (Stuss & Benson, 1986; Wehmeyer & Kelcher, 1995). Memory serves the writer in many ways. Working memory stores ideas as they are worked and reworked by the writer. Short-term memory is used for word recognition while writing. Long-term memory provides content and word knowledge as well as overall format. Automaticity of retrieving letters and words from memory and producing them contributes to the quality of text generation. WR ITI NG PROB LE MS Children with oral language impairments will most likely have writing impairments too. For many children with LI, writing difficulties do not decrease with age and the gap widens between their writing abilities and those of children developing typically. The content and organization of their writing suffer as more of their cognitive capacity is used for the lower-level mechanics of writing, such as spelling. Children with LLD have difficulties with all aspects of the writing process (Graham, Harris, MacArthur, & Schwartz, 1991; McFadden & Gillam, 1996; Roth, Spekman, & Fye, 1991; Troia, Graham, & Harris, 1999; Vallecorsa & Garriss, 1990; Wong, 2000). First, they have little knowledge of the writing process, thus children with LLD fail to plan and make few substantive revisions. Second, because of the time it takes and the difficulties encountered, children with LLD write very little on a given task.

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Third, clarity and organization are forsaken for spelling, handwriting, and punctuation, although children continue to have difficulties in all three areas. In other words, cognitive capacity is expended on low-order mechanics. Despite this, children with LLD make more grammatical and punctuation errors and produce fewer complex sentences than age-matched peers. They have difficulty with cohesive ties and unambiguous reference. Fourth, spelling often follows a maladaptive pattern in which words that can be spelled are substituted for those that cannot. In the process, meaning suffers. In narrative writing as in storytelling, children with LI lack mature internalized story schemes (Montague, Graves, & Leavell, 1991; Roth et al., 1991; Vallecorsa & Garriss, 1990). As noted in Chapter 8, the oral narratives of children with LI are often shorter with fewer episodes, contain fewer details, and often fail to consider the needs of the listener. Listeners are only rarely given cause and effect or character motivation. The oral and written narratives of children with LI have similar characteristics. Deficits in Executive Function When executive function is impaired, communication abilities are diminished, especially in socially demanding or complex linguistic tasks, such as writing. Executive function is especially important for the pragmatic aspects of communication, memory and retrieval, strategic thinking, perspective taking, and generalization. In addition to anatomical and physiological aspects of development, executive function is also vulnerable to academic and social failure. Both may slow development as children begin to realistically assess their abilities. Executive function impairment is most evident in children with TBI (Sohlberg, Mateer, & Stuss, 1993; Ylvisaker & Feeney, 1995). The high frequency of frontal lobe injury makes executive function particularly vulnerable for these children. Children with ADHD have been described as inattentive and impulsive, disorganized, unable to inhibit behavior, and ineffective learners, characteristics of those with impaired executive function. In nonexecutive function tasks, such as visuospatial processing, children with ADHD experience no difficulties. Children with LD minimize self-regulatory processes found in executive functions (Englert, Raphael, Fear, & Anderson, 1988). When they write, they follow a “retrieve-write” strategy in which they write whatever comes to mind, each sentence stimulating the next, with little thought to planning. The result is that they produce and elaborate very little. Revisions are ineffective and can be characterized by seeming indifference to the audience, inept detection of errors, and difficulty executing intended changes (Graham & Harris, 1999). Deficits in Spelling Writing and spelling are separate but correlated processes. Children with written-language deficits due to LLD, SLI, or other causes may have problems in either or both. In general, children have more difficulty with spelling if handwriting is also a problem (Berninger, Abbott, Rogan, Reed, Abbott, et al., 1998). Poor spellers view spelling as arbitrary and random. To them, spelling is difficult and ultimately unlearnable (Hughes & Searle, 1997). Adults with LD often cite spelling as their primary area of concern (Blalock & Johnson, 1987). Beyond the obvious difficulties for poor spellers are the parallel deficits seen in reading. Poor spellers have poor word attack or decoding skills and overrely on compensatory strategies, such as use of context for reading words (Bruck & Waters, 1990; Newman, Fields, & Wright, 1993).

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The misspellings of the poorest older spellers suggest the following patterns of spelling deficits (Moats, 1995): of liquids and nasals in rime or noninitial positions, as in SEF for self and RET for rent • Omission Omission in consonant clusters, especially in the syllable- and word-final positions, as in FAT for • fast of unstressed vowel, as in TELFON for telephone • Omission Vowel substitutions, as in TRI for try • Consonant substitutions that share some articulatory features, as in “t” for “d” or “m” for “n” • Omission of plural inflections • Omission or substitution of past tense inflections • Misspelling of difficult common words, such as their/there and to/too/two • Many poor spellers demonstrate primitive phonologically based errors even when they have high levels of orthographic knowledge (Treiman, 1997). Although most spellers shift to greater use of analogy (e.g., pillage is spelled like village) between second and fifth grade, poor spellers continue to rely on visual matching skills and phoneme position rules because of limited knowledge of sound-letter correspondences (Kamhi & Hinton, 2000). In other words, they continue to use the visual approach to learning that characterizes much younger spellers. In fact, spellers with dysgraphia seem incapable of changing their spelling of certain types of words (Treiman, 1997). Spelling deficits are only rarely caused by poor visual memory. Usually, deficits in spelling represent poor phonological processing and poor knowledge and use of phoneme-grapheme information. ASSESSM E NT OF WR ITI NG It is best to employ an evaluative tool that uses data from actual writing in varying contexts. One method of assessing writing in the classroom is through the use of portfolios of children’s writing (Paratore, 1995). Portfolios are a collection of meaningful writing selected by a child, SLP, and teacher that contains samples of the child’s writing over time, enabling the child to demonstrate progress. The wide variety helps to increase the validity of the sample. Allowing children to contribute fosters selfgrowth and monitoring. In addition, selection of teacher and SLP choices fosters collaboration. The writing contained within can also be used to demonstrate progress toward IEP goals. Guidelines for portfolio use in an initial evaluation are as follows (Manning Kratcoski, 1998): determination of the items to be included for variety over time • Careful Analysis appropriate for the different types of writing and the goals of the assessment • Appropriate persons contributing items • Items to be included in a portfolio may include SLP observation notes, work samples, and first drafts of writing samples, such as journal or learning log entries, and projects/papers, final drafts of the same, and peer and teacher evaluations. As mentioned, the SLP and teacher should collaborate to decide on the type of writing desired (N. Nelson & Van Meter, 2002). Narratives are best for young elementary school children (N. Nelson, 1998). Open-ended tasks, in which the child supplies all needed information, reveal more about a child’s

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writing than structured tasks in which the setting and characters are specified or in which the child retells a narrative. The latter types of tasks may be needed, however, for children with poor narrative skills. Older elementary school children or adolescents can provide expository writing samples. Expository writing, the writing of the classroom, is of several genres: procedural, descriptive, opinion, cause-and-effect, and compare-and-contrast. Samples of each should be collected if possible. Although the focus changes by type of expository writing, clarity of ideas is important in each genre. Executive function is best assessed within overall writing assessment or through dynamic assessment techniques mentioned in Chapter 3. There is a risk in separating the various functions and considering them separately from functional communication tasks (Fey, 1986). Data Collection Samples should be written in ink to allow the SLP to note revisions. The teacher or SLP should inform children that edits are fine and encourage them to do their best. It’s helpful to allow children to plan and to write drafts. Paper can be provided for notes and plans and should be collected along with the finished product. These can be added to the portfolio mentioned previously. Whenever possible, the SLP can observe the writing process for evidence of planning and organizing, drafting, writing, revising, and editing. Expository texts can be elicited by a number of procedures. For example, sequential/procedural texts can be elicited by asking the child, “Tell me how you make _____.” With the cause-and-effect genre, the SLP might say,“Tell me what might happen if _____.” Problem-solving genres can be encouraged with “How would you _____?” It is important to pose familiar and unfamiliar themes. Key words, such as describe, compare, contrast, cause, and solve can cue the child for the type desired. Added information can be obtained if children read their paper aloud while being audiotaped. This procedure aids the SLP in interpreting garbled or poorly spelled words. Data Analysis Writing can be analyzed on several levels, including textual, linguistic, and orthographic (spelling). At a textual level, the SLP can note compositional length, an indication of the amount of effort; quality, a holistic rating on the nature of the task; and discourse structure, the way in which text is related to the global topic or comments support the topic (Berninger, 2000). The child’s writing can be photocopied for mark-up and analysis. Of interest are the total number of words, clauses, and T-units. The use of T-units can help to avoid long run-on sentences but does not reflect “grammatical accuracy,” so further internal analysis must be performed (N. Nelson & Van Meter, 2002). These are outlined in Chapter 8. Writing conventions, such as capitalization and punctuation, plus the use of sentences and paragraphs, should be noted. Spelling can be analyzed as explained below. By adolescence, the expository writing of typically developing children has made several strides. Changes found in persuasive writing include increases in essay length, mean length of utterance measured in words, relative clause production, and use of literate words (Nippold, Ward-Lonergan, & Fanning, 2005). Literate words include adverbial conjuncts, discussed earlier (however, finally, in conclusion, personally), abstract nouns (kindness, loyalty, benefits, pleasure), and metalinguistic and metacognitive verbs (think, remember, reflect, agree, persuade, confess). The greater flexibility of older writers is seen in presentation of greater numbers of reasons and acknowledgment of diverse perspectives and differing opinions. Average values are presented in Table 13.7. Individual variation is great, and there is much

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TABLE 13.7

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401

Parameters of Persuasive Writing by Age Age 11

MLU-W (Mean length of utterance in words) Range Below 1 SD Total words Range Below 1 SD Word types as percentage of total words Adverbial conjuncts Range Abstract nouns Range Metaverbs Range Total utterances Range Below 1 SD Relative clauses as percentage of total utterances Total reasons

Age 17

Age 24

11.3 5.5–19.3 5.5–8.3 146.9 33–297 33–88

13.9 8.9–23.8 8.9–11.9 188.5 86–321 86–139

15.9 11.1–27 11.1–14.6 262.9 146–481 146–215

0.3% 0–3.9% 2.7% 0–6.3% 1.3% 0–3.7% 13.6 4–30 4–9.8 11.7% 6.8

0.77% 0–2.8% 5.7% 1.8–17.3% 1.9% 0–5.9% 14.7 5–33 5–10.6 16.7% 7.9

0.83% 0–2.5% 7.8% 3.7–16.4% 2% 0–4.6% 17.3 7–37 7–12.7 20.8% 12.7

Source: Values taken from Nippold, Mansfield, & Billow (2007).

overlap. It’s important to recognize that these values will vary by task and represent a 20-minute writing sample based on a presentation of three diverse points of view and the instructions to state one’s own perspective supported by several good reasons for the opinion. Readers are urged to consult the original research for data collection methods. Spelling Assessment Although it may seem straightforward, spelling deficits are very complex and can be difficult to describe. Collection should be of sufficient quantity to allow for a broad-based analysis of error types. Data Collection. Spelling deficits should be assessed through both dictation and connected writing (Masterson & Apel, 2000). In dictation, either within standardized testing or from word inventories, the SLP or teacher reads words while the child writes them. Standardized tests include the Test of Written Language (Hammill & Larson, 1996), Test of Written Spelling (Larson & Hammill, 1994), and the Wide Range Achievement Test–3 (Wilkinson, 1995). Word inventories, either preselected—such as those found in Bear, Invernizzi, Templeton, and Johnston (2000)—or SLP-designed, should be developmental in nature and include several phonemegrapheme variations, including, but not limited to, single consonants in various positions in words, consonant blends, morphological inflections, diphthongs, digraphs or two letters for one phoneme such as “ch” and “sh,” and complex derivations as in omit-omission. The choice of words will vary with the age and functioning level of the child and should not be bizarre or totally unfamiliar to the child.

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The number of words must be sufficient to identify patterns of functioning. Using 50 to 100 words is probably adequate, although more is desirable (Masterson & Apel, 2000). Single-word spelling may be of little real value because decontextualized spelling does not measure a child’s ability in a real communicative context (Moats, 1995). More functional connected writing can be generated in response to pictures or narratives or provided portfolios. In a variation, the child can write an original sentence or narrative using representative words taken from word lists (Buchannan, 1989; Routman, 1991). Testing tasks that require a child to select correctly spelled words may seen like a good assessment tool but may be of little actual value (Ehri, 2000). These tasks occur infrequently in the real world of the child and thus are not functional for either assessment or intervention. Data from other areas of language functioning are also of interest. The SLP along with other team members should assess the child’s reading, phonological awareness, and morphology use because of the close correlation of each of these areas with spelling. Data Analysis. Descriptive analysis should focus on orthographic patterns evident in the child’s spelling (Bear et al., 2000). While individual errors are significant, error patterns are important for intervention. Of interest are the most frequent and the lowest level patterns. The SLP tries to determine the type of error reflected in the child’s spelling of each incorrect word. It’s helpful to analyze base words (teach), inflected words (teaches), and derived words (teacher) separately to see if errors are related to any specific word form. Table 13.8 presents a classification system that can be helpful and relates to the developmental process described earlier. TABLE 13.8

Levels of Spelling Analysis

Level

Description

Preliterate

Unrecognizable symbols, some letters. Prephonetic spelling in which letters and sounds do not correspond. Uses primarily letter names. Semi-phonetic spelling evidencing a few sound-letter relationships, but letters are missing, especially vowels.

Early letter name

Example

T for tea, MT for empty, TP for top

JRAK, CHRAC, TRAC for track

Letter name

Spelling based on letter names and speech sounds. Consonant clusters usually reduced. Although many misspellings occur, the child has a notion of sound-letter associations.

Within-word pattern

Orthographic patterns, such as long and RATE, RAT, CONE, CON, and short vowel patterns used along with spelling STOPS, WALKED, SINGING by meaning, i.e., morphological inflections.

Syllable juncture

Uses doubling principle and patterns in both LITTLE, BUBBLE, STRAIGHT, stressed and unstressed syllables. VACATION

Derivational constancy

Uses roots and derivations consistently. Uses multiple strategies.

Source: Adapted from on Ehri (1986); Gentry (1982); Henderson (1990).

STARING and STARRING, NATURE and NATURAL

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Spelling is the result of segmenting a word into phonemic elements and selecting the appropriate graphemes. Unfortunately, for the beginning speller, not all phonemic components are readily apparent. Consonants often become lost in blends. In analyzing the spelling sample, the SLP should note consonant blends by location within the syllable and word and by the presence of other phonemes. Internal word consonants are omitted more than those at either end, thus snack might become SAK. The SLP should seek phonemic (EKWAT for equate), morphologic (omits morphologic markers), or semantic (confuses similar sounding words, as in there, their, and they’re) explanations for error patterns (Bourassa & Treiman, 2001). Phonological processing and spelling are related for elementary school children, less so for older students who use multiple spelling strategies (Berninger et al., 1994). If the child uses an incorrect letter, the error most likely represents a problem in phonological awareness. Inserted or deleted letters may represent a speech perception problem (Moats, 1995). In addition, the SLP should look at each error to determine the child’s orthographic system knowledge. This includes letter selection and position constraints. For example, “ts” is an acceptable blend but is constrained by position and is not acceptable at the beginning of a word, with the exception of the Russian “tsar” and the Japanese “tsunami.” Such knowledge addresses the question Could this be a word? Has the child’s error violated acceptable English spelling or would the resultant word be an acceptable one? Orthographic constraints are presented in detail in Mersand, Griffith, and Griffith (1996). I NTE RVE NTION FOR WR ITI NG I M PAI R M E NT Intervention for writing may involve both general training and more specific techniques for narrative and expository forms. To learn to write, you must write, so intervention needs to focus on the actual writing process. Generalization is enhanced if intervention is curriculum-based and within authentic writing projects. Executive function can be targeted within the writing process using a goal-plan-do-review format (Ylvisaker & Feeney, 1996; Ylvisaker & Szekeres, 1989; Ylvisaker, Szekeres, & Feeney, 1998). Although there is little an SLP can do to alleviate the root causes of TBI, ADHD, or other impairments relative to executive function, he or she can provide external support to enable children with these impairments to experience some level of success (Ylvisaker & DeBonis, 2000). This should not be interpreted to mean that the SLP acts as the child’s executive function. In that situation, little changes for the child. SLPs give children the tools to facilitate their lives. SLPs change behaviors and processes. In the end, we cannot live our client’s lives for them. Intervention can begin by allowing children to select their own topics. This increases motivation and shifts the focus to ideas. Mechanics will come later. Topic selection works well with small groups of children and the sharing process often generates more ideas. In the planning phase, the SLP and child can brainstorm ideas for inclusion in the writing (Troia, Graham, & Harris, 1999). Drawings and ideational maps or spider diagrams can help. For narratives, children might draw a few simple pictures and organize them in the appropriate order. Computer programs, such as The Amazing Writing Machine (Broderbund, 1999) and The Ultimate Writing and Creativity Center (The Learning Company), can also be helpful. It is also helpful for the child to focus on the potential audience. The SLP can ask questions such as the following (Graham & Harris, 1999): Who will read this paper? What do the readers know?

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What do the readers need to know? Why are you writing? The SLP and child may prefer to use computers as an assistive technology for writing (MacArthur, 2000). Software, such as Inspiration (Inspirations Software, 1997), can aid text generation, and the result is easily modifiable by the child or teacher. Although the technology itself is unlikely to improve writing, it does remove the handwriting difficulties for some children. Typing can also detract from text development, and computer use can result in new burdens for working memory. Having said this, we should note that children with LD who receive training in executive function along with word processing make greater gains in the quality of their writing than children instructed only in executive function (MacArthur, Graham, Schwartz, & Schafer, 1995). Word processing experience alone, however, does not improve overall quality (MacArthur & Graham, 1987; MacArthur et al., 1995; Vace, 1987). A word about spellcheckers and grammar checkers seems in order. Neither are foolproof, as I’m sure you know. Spellcheckers will be discussed in the following section on spelling. Grammar checkers miss many errors, especially if there are multiple spelling errors, and can easily confuse the writer who is left to figure out just what the error is. Some grammar checkers are very resistant, and only a strong writer can continue to insist on the structure desired. I sometimes have to change it back three times before I can override the system. Word-prediction programs, such as Co:Writer (D. Johnston, 1998), Write Away 2000 (Information Services, 1989), and Clicker 5 (2005), are helpful, but mostly for spelling (MacArthur, 2000; Ylvisaker & DeBonis, 2000). Most have speech synthesis too. Inputs vary from spelling only to spelling plus grammar. It’s important that the word-prediction program’s vocabulary match the writing task of the child (MacArthur, 1999; Zhang, Brooks, Fields, & Redelfs, 1995). For example, Co:Writer incorporates the word frequency and topic of the writer. Write Away 2000 allows the child or teacher to add vocabulary, and content-specific prompts can be added to expand the vocabulary. In contrast, Clicker Plus allows the child or teacher to download specific words. Finally, speech recognition software allows children to compose by dictation, resulting in longer and higher quality papers by children with LLD (Graham, 1990). Children must be instructed to speak clearly in order to improve speech recognition and to dictate punctuation and formatting. Speechrecognition software cannot overcome oral language difficulties, although these can be moderated with the additional use of grammar checkers. Narrative Writing Narrative writing may require explicit instruction in story structure as outlined in Chapter 11. Story maps using pictures or story frames may be necessary initially but should be faded gradually as the child assumes more responsibility for the narrative. Story frames (Fowler, 1982) are written starters for each main-story grammar element. The child completes the sentence and continues with that portion of the narrative. Cards or checklists can also be used to remind the child of story grammar elements (Graves, Montague, & Wong, 1990; Montague et al., 1991). During the writing process, the SLP can use story guides, prompts, and acronyms to aid the child. Story guides are questions that help a student construct the narrative, while prompts are story beginning and ending phrases (Graves et al., 1990; Montague et al., 1991; Thomas, Englert, & Morsink, 1984). Acronyms, such as SPACE for setting, problem, action, and consequent events, can also act as prompts for guiding writing (Harris & Graham, 1996). Children can be encouraged to write more with verbal prompts such as “Tell me more” or “What happened next?”

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Feelings and motivations found in mature narratives are often missing from the stories of children with LI. These elements can be targeted with pictures and questions such as “How do you think she felt?” (Roth, 2000). Expository Writing Procedures for intervention with expository writing include collaborative planning; individual, independent writing; conferencing with the teacher/SLP and peers; individual, independent revising; and final editing (Wong, 2000). Whatever the expository genre involved, collaborative planning is important, including planning, writing, and revising. In the first step, the child should think aloud and solicit opinions. This is an opportunity for the child to hear alternative views and to reconcile these with his or her own. For opinion papers, the child first needs to pick a topic. These might come from a prepared list, from the child, or from topics discussed in class. Once the topic is selected and discussed in small groups, with a peer, and/or with the SLP, the SLP can give the child a planning sheet to help organize her or his thoughts. It might include two columns: What I believe and What someone else believes (Wong, 2000). After the child has completed the sheet, either with help or working alone, the SLP can help the child form dyads of opposing views. This is a great time for verbal repartee, challenging, and helping the child clarify his or her views and prepare for independent writing. Writing, although independent, can be fostered through the use of a prompt card containing key words for each major section of the paper (Wong, Butler, Ficzere, & Kuperis, 1996). Table 13.9 presents a sample prompt card. After the child has completed the paper, he or she conferences with peers for feedback while the SLP mediates. The child revises the paper based on feedback. TABLE 13.9

Sample Prompt Card for Opinion Writing

Section of Paper

Examples

Introduction

In my opinion . . . I believe . . . From my point of view . . . I agree with . . . I disagree with . . .

Counter Opinion

Supporting words: first, second, finally, for example, most important is . . . , consider, think about, remember Although . . . However, . . . On the other hand, . . . To the contrary, . . .

Conclusion

Even though . . . In conclusion . . . After considering both sides, . . . To summarize, . . .

Source: Adapted from Wong, Butler, Ficzere, & Kuperis (1996b).

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At each stage in the process, the child should record progress on a checklist. In addition to providing a model for the writing process, the checklist can motivate the child as she or he finishes each step. For compare-and-contrast writing, the planning process can be similar. Again, the topic—which entities are to be compared—can come from prepared lists, the child, or the curriculum. Through brainstorming, the child and SLP try to answer the question “How can we compare them?” SLPs should be prepared for some comparisons that are very “original,” especially from children who have perceptual deficits and may view the world quite differently from adults. Again, the child can be helped with writing prompts, such as the following (Ylsivaker & DeBonis, 2000): In this essay, I’m going to compare and contrast. . . I have chosen two (any number) features: . . . In conclusion, . . . As mentioned previously, peer, teacher, and SLP review and feedback can help the child revise. Intervention for Spelling Words are the vehicles for teaching alphabetic and orthographic principles (Berninger,Vaughan, Abbott, Brooks, Abbott, et al., 1998). The SLP is not the “spelling teacher.” It is as inappropriate for the SLP to teach this week’s spelling list as it is to teach this week’s vocabulary. Rather the SLP’s role is to help children learn to spell. Much of the discussion of phonological awareness intervention is also applicable here. The benefits to spelling of early phonological awareness training are well documented. In addition to spelling better by mid-elementary school than children who did not receive preschool phonological awareness training, children who did receive such training are more likely to employ morphological awareness— knowledge of root words and affixes—when spelling (Kirk & Gillon, 2007). Words selected for intervention should be individualized for each child and reflect both the curriculum and the child’s desires (Graham, Harris, & Loynachan, 1994). Spelling intervention should be integrated into real writing and reading within the classroom. It is best if intervention can occur when the child is actually writing and he or she can be reminded of alphabetic and orthographic principles (Scott, 2000). Words misspelled in class can be analyzed by the SLP. Spelling strategies can be discussed with the child using these words. Spelling can be taught within teaching of general executive function in which the child is taught to proofread, correct, and edit. Peer editing is also effective (Graham, 1999). If needed, spelling intervention should begin with alphabetic principles, connecting sounds and letters. Targeted words can be taught as explained below but expanded into onset-rime training to facilitate overall spelling ability (Berninger, Vaughan et al., 1998). Children with LD benefit from multisensory input such as pictures, objects, or actions (Graham, 1999). Several multisensory study techniques have been proposed. In the 5-Step Study Strategy, the child (1) says the word; (2) writes it while saying it again; (3) checks spelling and; (4) if correct, traces it while saying it again; then finally, (5) writes the word and checks the spelling (Graham & Freeman, 1986). In the Horn Method 2, the child focuses on the internal structure of the word (Horn, 1954). Words are pronounced carefully, followed by carefully looking at each part of the word. Letters are pronounced in sequence, then recalled. The child then writes the word, checks, and if incorrect, respells and checks again.

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The 8-Step Method is designed for pencil or computer (Berninger, Abbott, et al., 1998). First, the SLP sweeps his or her finger over the word and pronounces it out loud. Next, to call attention to the phoneme-grapheme correspondence, the SLP says the word again emphasizing sounds that correspond to colored letter groupings. For example, /b/-/i/-/d/ for “b”-“ea”-“d.” On the third pass, the child names the letters as the SLP points to each in sequence. The child then closes his or her eyes and visualizes the word. In step five, while his or her eyes are closed, the child spells the word out loud. Following this step, the child writes the word, then compares it to the sample. In the final step, the SLP reinforces the child’s correct spelling. If the child’s spelling is incorrect, the SLP points out the difference between the sample and the child’s attempt and repeats the previous steps. Word analysis and sorting tasks can be used to strengthen the alphabetic principle (Scott, 2000). Patterns to be taught should be identified from the child’s misspellings. Minimum pairs that differ on the bases of these processes can be used to demonstrate the lexical consequences of misspelling (Masterson & Crede, 1999). The SLP should use known and unknown words to facilitate generalization. Sorting tasks will differ based on the spelling level of the child (Scott, 2000). At the letter-name level of development, words can be sorted or grouped by sounds and location, as in initial consonants or initial digraphs (two letters = one sound,“sh” = /Ú/). Minimal pairs might contrast short vowels, long and short vowels, single consonants and blends, and one digraph with another. In contrast, with children at the within-word level, the SLP can sort by orthographic patterns, such as vowel patterns, rimes, and homophones. In the later stages of syllable juncture and derivational constancy, words can be grouped by syllable juncture principles and meaning, including inflectional suffixes and simple prefixes and derivational suffixes, consonant doubling with open and closed syllables, compound words, changing final “y” to “i,” and word roots. Minimal pairs may contrast variants of inflectional suffixes, such as “-s” and “-es,” and base words with derivational suffixes, as in teach/teacher. Computers are helpful and encourage editing, although spellcheckers are not foolproof and the child may learn little. In general, spellcheckers miss words in which the misspelling has inadvertently produced another word. Suggested spelling may also confound the child with poor word attack skills. In addition, suggested spellings may be far afield if the original word has multiple misspellings. Spellcheckers help only about 37 percent of the time for children with LD, a lower percentage than found among children developing typically (MacArthur, Graham, Haynes, & DeLaPaz, 1996). On the other hand, word-prediction programs reduce spelling errors of children with LI by over half, although the user must get the initial letters correct for the program to work effectively (Newell, Booth, Arnott, & Beattie, 1992). If children with LI are taught to spell phonetically when unsure of the correct spelling, spellcheckers generate more correct suggestions. Proofing and editing on a hard copy also seem to increase the number of correctly spelled words (McNaughton, Hughes, & Ofiesh, 1997). Internet searches can foster spelling learning because correct spelling is needed to complete searches successfully. Spelling intervention is more meaningful if it occurs within authentic writing exercises, such as curriculum-based writing. Within these activities, children can be taught to ask themselves if they can identify word part or initial or final sounds. They can try to identify similarly sounding words or identify locations where the word has appeared. These can be checked for the correct spelling. When all else fails, the student should try to find the word in the dictionary. This may be facilitated by use of a personal or class dictionary or dictionaries produced for different classroom topics. Computer spellcheckers may also be helpful.

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Conclusion And so, we reach the end of this text. I hope that I have challenged your thinking along the way and that you’ll use this book as a reference. Even in the area of literacy, functional communication is important. Using real reading and writing samples. Training for the kinds of reading and writing that the child is encountering in the classroom. And we have come full circle. Intervention in the classroom is about as close as an SLP in the schools can get to the actual use environment of the child. Other aspects of the model that we have discussed may also be present. For example, parents may be involved in their children’s training. Cues and consequences should still be as natural as possible. Literacy being as functional as possible is especially important. Remember. . . . Decontextualized training routinely fails at the level of generalization . . . (Ylvisaker & DeBonis, 2000, p. 43)

Appendix

A

Considerations for CLD Children

409

410

Appendix A

M

ost regional and ethnic dialects differ only slightly from the standard or are used by a limited number of individuals. Three ethnic dialects, however, represent rather large segments of the U.S. population and have some very important differences with Standard American English. These dialects are African American English, Latino English, and Asian English. African American English is used primarily by working-class African Americans in the urban northern United States and rural African Americans in the South. Not every African American uses African American English, and not everyone who uses it is African American. Latino English and Asian English are probably misnomers. Latino English, as used here, is a composite of the English used by many speakers who are bilingual and learned English as a second language. Individual variations represent the age of learning and level of mastery, the Spanish dialect used, socioeconomic status, and where the person lives in the United States. Asian English is also a composite, but of bilingual speakers of Asian languages who learned English as a second language. As such, Asian English probably does not exist except to simplify our discussion. Asians speak many languages, and each has a different effect on the learning of English. In addition to the original language learned, other individual differences may reflect the same factors as those of Latino English. Each dialect is discussed in some detail. Where possible, information has been reduced to tables to aid presentation. Each dialect is compared with Standard American English, an idealized norm uninfluenced by the dialectal differences each person possesses.

African American English African American English reflects the complex racial and economic history of the United States and the migration of African Americans from the rural South to the urban North after World War II. Regional differences exist to some degree. The major variations between Standard American English and African American English in phonology, syntax, and morphology are presented in Tables A.1 and A.2.

TABLE A.1 Phonemic Contrasts Between African American English and Standard American English Position in Word SAE Phonemes

Initial

/p/ /n/ /w/

Omitted in specific words (I ’as, too!)

Medial

Final*

Unaspirated /p/

Unaspirated /p/ Reliance on preceding nasalized vowel

Considerations for CLD Children

TABLE A.1

411

Continued Position in Word

SAE Phonemes

/b/ /g/ /k/ /d/

Initial

Omitted in specific words (I ’on’t know)

/ŋ/ /t/ /l/ /r/ /θ/

Unaspirated /t/ or /f/

/v/ /δ/

Sometimes /b/ /d/

/z/

Medial

Final*

Unreleased /b/ Unreleased /g/ Unaspirated /k/ Unreleased /d/

Unreleased /b/ Unreleased /g/ Unaspirated /k/ Unreleased /d/

/n/ Unaspirated /t/ Omitted before labial consonants (help-hep) Omitted or /ə/

/n/ Unaspirated /t/ “uh” following a vowel (Bill-Biuh) Omitted or prolonged vowel or glide Unaspirated /t/ or /f/ (bath-baf ) Sometimes /b/ /d/, /v/, /f/

Unaspirated /t/ or /f/ between vowels /b/ before /m/ and /n/ /d/ or /v/ between vowels Omitted or replaced by /d/ before nasal sound (wasn’t-wud’n)

Blends /str/ becomes /skr/ /ʃr/ becomes /str/ /θr/ becomes /θ/ /pr/ becomes /p/ /br/ becomes /b/ /kr/ becomes /k/ /gr/ becomes /g/ Final Consonant Clusters (second consonant omitted when these clusters occur at the end of a word) /sk/ /nd/ /sp/ /ft/ /ld/ /dd/ /st/ /sd/ /nt/ *Note weakening of final consonants. Source: Data drawn from Fasold & Wolfram (1970); Labov (1972); F. Weiner & Lewnau (1979); R. Williams & Wolfram (1977).

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TABLE A.2 Grammatical Contrasts Between African American English and Standard American English African American English Grammatical Structure

Possessive -’s Nonobligatory where word position expresses possession. Get mother coat. It be mother’s.

SAE Grammatical Structure

Obligatory regardless of position. Get mother’s coat. It’s mother’s.

Plural -s Nonobligatory with numerical quantifier. He got ten dollar. Look at the cats.

Obligatory regardless of numerical quantifier. He has ten dollars. Look at the cats.

Regular past -ed Nonobligatory; reduced as consonant cluster. Yesterday, I walk to school.

Obligatory. Yesterday, I walked to school.

Irregular past Case by case, some verbs inflected, others not. I see him last week.

All irregular verbs inflected. I saw him last week.

Regular present tense third-person singular -s Nonobligatory. She eat too much.

Obligatory. She eats too much.

Irregular present tense third-person singular -s Nonobligatory. He do my job.

Obligatory. He does my job.

Indefinite an Use of indefinite a. He ride in a airplane.

Use of an before nouns beginning with a vowel. He rode in an airplane.

Pronouns Pronominal apposition: pronoun immediately follows noun. Momma she mad. She ...

Pronoun used elsewhere in sentence or in other sentence; not in apposition. Momma is mad. She...

Future tense More frequent use of be going to (gonna). I be going to dance tonight. I gonna dance tonight. Omit will preceding be. I be home later.

More frequent use of will. I will dance tonight. I am going to dance tonight. Obligatory use of will. I will (I’ll) be home later.

Negation Triple negative. Nobody don’t never like me. Use of ain’t. I ain’t going.

Absence of triple negative. No one ever likes me. Ain’t is unacceptable form. I’m not going.

Modals Double modals for such forms as might, could, and should. I might could go.

Single modal use. I might be able to go.

Considerations for CLD Children

TABLE A.2

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Continued

African American English Grammatical Structure

SAE Grammatical Structure

Questions Same form for direct and indirect. What it is? Do you know what it is?

Different forms for direct and indirect. What is it? Do you know what it is?

Relative pronouns Nonobligatory in most cases. He the one stole it. It the one you like.

Nonobligatory with that only. He’s the one who stole it. It’s the one (that) you like.

Conditional if Use of do for conditional if. I ask did she go.

Use of if. I asked if she went.

Perfect construction Been used for action in the distant past. He been gone.

Been not used. He left a long time ago.

Copula Nonobligatory when contractible. He sick.

Obligatory in contractible and uncontractible forms. He’s sick.

Habitual or general state Marked with uninflected be. She be workin’.

Nonuse of be; verb inflected. She’s working now.

Source: Data drawn from Fasold & Wolfram (1970); R. Williams & Wolfram (1977).

Latino English Speakers who are bilingual may move back and forth between both languages in a process called code switching. The amount of code switching depends on the speaker’s mastery of the two languages and on the audience being addressed. Of course, a great deal of code switching makes the speaker’s English incomprehensible to the listener who is monolingual American English. Most characteristics of Latino English reflect interference points, or points where the two languages differ, thus making learning somewhat more difficult. For example, the speaker of Latino English may continue to use the Spanish possessive form in which the owner is preceded by the entity owned, as in “the dress of Mary.” The major variations between Standard American English and Latino English in phonology, syntax, and morphology are presented in Tables A.3 and A.4.

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TABLE A.3

Phonemic Contrasts Between Latino English and Standard American English Position in Word

SAE Phonemes

Initial

/p/

Unaspirated /p/

Medial

Omitted or weakened

/m/ /w/

Omitted /hu/

Omitted

/b/

Omitted, distorted, or /p/

/g/ /k/

Final*

Omitted, distorted, or /k/ Unaspirated or /g/

Omitted, distorted, or /g/

/f/

Omitted

/d/ /ŋ/

/n/

/j/

/d*/

Dentalized

Omitted, distorted, or /t/

/d/

/n/ (sing-sin)

/s/, /tʃ/

/tʃ/ (wish-which)

/t/

Omitted

/ʃ/

/tʃ/

/tʃ/

/ʃ/ (chair-share)

/ʃ/

/ʃ/ (watch-wash)

/r/

Distorted

Distorted

Distorted

/d/

/d/

/j/

/ʃ/

/θ/

/t/, /s/ (thin-tin, sin)

Omitted

/ʃ/, /t/, /s/

/v/

/b/ (vat-bat)

/b/

Distorted

/z/

/s/ (zip-sip)

/s/ (razor-racer)

/s/

/δ/

/d/ (then-den)

/d/, /θ/, /v/ (lather-ladder)

/d/

Blends /skw/ becomes /eskw/* /sl/ becomes /esl/* /st/ becomes /est/* Vowels /I/ becomes /i/ (bit-beet) *Separates cluster into two syllables.

Source: Data drawn from J. Sawyer (1973); F. Weiner & Lewnau (1979); F. Williams, Cairns, & Cairns (1971).

Considerations for CLD Children

TABLE A.4

415

Grammatical Contrasts Between Latino English and Standard American English

Latino English Grammatical Structure

Possessive -’s Use post-noun modifier. This is the homework of my brother. Article used with body parts. I cut the finger. Plural -s Nonobligatory. The girl are playing. The sheep are playing. Regular past -ed Nonobligatory, especially when understood. I talk to her yesterday. Regular third-person singular present tense -s Nonobligatory. She eat too much. Articles Often omitted. I am going to store. I am going to school. Subject pronouns Omitted when subject has been identified in the previous sentence. Father is happy. Bought a new car. Future tense Use go + to. I go to dance. Negation Use no before the verb. She no eat candy. Question Intonation: no noun-verb inversion. Maria is going? Copula Occasional use of have. I have ten years. Negative imperatives No used for don’t. No throw stones. Do insertion Nonobligatory in questions. You like ice cream? Comparatives More frequent use of longer form (more). He is more tall. Source: Data drawn from Davis (1972); Taylor (1986a).

SAE Grammatical Structure

Post-noun modifier used only rarely. This is my brother’s homework. Possessive pronoun used with body parts. I cut my finger. Obligatory, excluding exceptions. The girls are playing. The sheep are playing. Obligatory. I talked to her yesterday. Obligatory. She eats too much. Usually obligatory. I am going to the store. I am going to school.

Obligatory. Father is happy. He bought a new car. Use be + going to. I am going to the dance. Use not (preceded by auxiliary verb where appropriate). She does not eat candy. Noun-verb inversion usually. Is Maria going? Use of be. I am ten years old.

Don’t used. Don’t throw stones. Obligatory when no auxiliary verb. Do you like ice cream? More frequent use of shorter -er. He is taller.

416

Appendix A

Asian English Chinese culture and language have for centuries influenced all other Asian cultures and languages. Other cultures, such as that of the Indian subcontinents, have influenced nearby Asian neighbors. Colonial occupation, especially by the French in Indochina, also has influenced the culture and language of the affected region. The most widely used languages—Chinese, Filipino, Japanese, Khmer, Korean, Laotian, and Vietnamese—represent only a portion of the languages of the area. Each language contains many dialects and has distinct linguistic features. It is therefore impossible to speak of an Asian English dialect. Instead, I shall attempt to describe the major overall differences between Asian English and Standard American English. These major or differences in phonology, syntax, and morphology are listed in Tables A.5 and A.6. TABLE A.5

Phonemic Contrasts Between Asian English and Standard American English Position in Word

SAE Phonemes

Initial

Medial

Final

/p/ /s/ /z/ /t/ /tʃ/ /ʃ/ /r/, /l/ /θ/ /d/ /v/

/b/**** Distortion* /s/** Distortion* /ʃ/**** /s/** Confusion*** /s/ /d/ or /z/*** /f/*** /w/** /z/* /d/***

/b/**** Distortion* /s/** Distortion* /ʃ/**** /s/** Confusion*** /s/ /d/ or /z/*** /f/*** /w/** /z/* /d/***

Omission Omission Omission Omission Omission Omission Omission Omission Omission Omission Omission Omission Omission

/δ/

Blends Addition of /ə/ between consonants*** Omission of final consonant clusters**** Vowels Shortening or lengthening of vowels (seat-sit, it-eat*) Difficulty with /I/, /ɔ/ and /æ/, and substitution of /e/ for /æ/** Difficulty with /I/, /æ/, /ɔ/, and /ə/**** *Mandarin dialect of Chinese only **Cantonese dialect of Chinese only ***Mandarin, Cantonese, and Japanese ****Vietnamese only

Source: Adapted from Cheng (1987).

Considerations for CLD Children

TABLE A.6

417

Grammatical Contrasts Between Asian English and Standard American English

Asian English Grammatical Structure

Plural -s Not used with numerical adjective: three cat Used with irregular plural: the sheeps Auxiliaries to be and to do Omission: I going home. She not want eat. Uninflected: I is going. She do not want eat. Verb have Omission: You been here. Uninflected: He have one. Regular past -ed Omission: He talk yesterday. Overgeneralization: I eated yesterday. Double-marking: She didn’t ate. Interrogative Nonreversal: You’re late? Omitted auxiliary: You like ice cream? Perfect marker Omission: I have write letter. Verb-noun agreement Nonagreement: He go to school. You goes to school. Article Omission: Please give gift. Overgeneralization: She go the school. Preposition Misuse: I am in home. Omission: He go bus. Pronoun Subjective/objective confusion: Him go quickly. Possessive confusion: It him book. Demonstrative Confusion: I like those horse. Conjunction Omission: You I go together. Negation Double-marking: I didn’t see nobody. Simplified form: He no come. Word order Adjective following noun (Vietnamese): clothes new. Possessive following noun (Vietnamese): dress her. Omission of object with transitive verb: I want. Source: Adapted from Cheng (1987).

SAE Grammatical Structure

Used regardless of numerical adjective: three cats Not used with irregular plural: the sheep Obligatory and inflected in the present progressive form: I am going home. She does not want to eat. Obligatory and inflected: You have been here. He has one. Obligatory, nonovergeneralization, and single-marking: He talked yesterday. I ate yesterday. She didn’t eat.

Reversal and obligatory auxiliary: Are you late? Do you like ice cream? Obligatory: I have written a letter.

Agreement: He goes to school. You go to school. Obligatory with certain nouns: Please give the gift. She went to school. Obligatory specific use: I am at home. He goes by bus.

Subjective/objective distinction: He gave it to her. Possessive distinction: It’s his book. Singular/plural distinction: I like that horse. Obligatory use between last two items in a series: You and I are going together. Mary, John, and Carol went. Single obligatory marking: I didn’t see anybody. He didn’t come.

Most noun modifiers precede noun: new clothes. Possessive precedes noun: her dress. Use of direct object with most transitive verbs: I want it.

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Appendix

B

Language Analysis Methods

419

420

Appendix B

Assigning Structural Stage/Complex Sentence Development In Assigning Structural Stage, Miller (J. Miller, 1981) proposes a three-tiered analysis that includes MLU, percentage correct of Brown’s 14 morphemes, and sentence analysis. These three measures enable the SLP to determine the stage of development and to describe the forms used. Although less precise than Developmental Sentence Scoring (DSS) (L. Lee, 1974), Assigning Structural Stage is more descriptive and prescriptive in nature. After determining the child’s stage of language development, the SLP can target linguistic forms in the next stage (Prutting, 1979). Analysis begins by collecting a language sample. The SLP collects 50 to 100 utterances or 15 minutes of conversation, whichever is larger, from the child for analysis. Unlike for DSS, these utterances do not have to be sentences. First, the SLP calculates MLU to determine the stage of development and the approximate language age of the child. MLU calculation is discussed in Chapter 7. After determining MLU, the SLP decides on the analysis method to follow. He or she may choose Assigning Structural Stage and/or Complex Sentence Development. If the MLU of the child is below 3.0, the SLP uses only Assigning Structural Stage. If the child’s MLU is above 4.5, the SLP uses only Complex Sentence Development. For MLUs of 3.0 to 4.5, the SLP uses both procedures. In Assigning Structural Stage, the SLP calculates the percentage correct for Brown’s 14 morphemes. A minimum number of occurrences or possibilities of occurrence are needed before the SLP can decide on consistency or inconsistency of use or nonuse. The child should attempt a morpheme at least four times before a percentage correct figure is calculated. The percentage correct value is determined by dividing the number of correct appearances by the total number of obligatory contexts. After calculating the percentage correct, the SLP again can attempt to describe the child’s stage of language development. Next, the SLP analyzes each utterance within four possible categories of noun phrase, verb phrase, and negative and interrogative development. Utterances are divided into noun and verb phrases where applicable, and each phrase is assigned to the stage of development that best describes its structures. Negative or interrogative utterances are further assigned to stages representing their level of development. The SLP should be familiar with the information Miller (1981) presents for each stage of development. Some of this information is presented in Table 7.16, although Miller presents a great deal more. The analysis process is demonstrated here by using some of the information in Table 7.16. Consider the child’s utterance, “Want a big doggie.” The noun phrase a big doggie has been expanded by the addition of an article and an adjective to the noun. This noun phrase occurs in the object position of the sentence. Expansion of the noun phrase only in the object position is an example of Stage II (see intrasentence column of Table 7.16). Therefore, this sentence represents noun phrase development characteristic of Stage II. The verb phrase is unelaborated, and no subject is present. This represents Stage I development. Complex Sentence Development is used similarly, but different samples and categories are used for analysis. Analysis is based on a 15-minute sample of the child’s communication, rather than on 50 utterances. For children with MLUs between 3.0 and 4.5, these samples can overlap. Five aspects of complex sentences are noted: percentage of both conjoined and embedded sentences within the sample, type of embedding, conjoining, conjunctions, and the number of different conjunctions. At each stage,

Language Analysis Methods

421

development is described by the forms exhibited by 50 to 90 percent and by greater than 90 percent of the children. Limited data from Complex Sentence Development are incorporated into Table 7.16. By postStage V, 90 percent of children should be using and within a 15-minute sample. To complete a full analysis, the SLP should consult Complex Sentence Development (J. Miller, 1981). Each sentence is analyzed by using Assigning Structural Stage and/or Complex Sentence Development, and the data are summarized. Most likely, the child will exhibit language forms in each stage of development. Now, the SLP must use his or her skill. Even mature language users occasionally use language forms that are characteristic of less mature learning. Adults use many one-word utterances everyday. These forms are not the most characteristic forms, however, and the SLP must gather a summary of overall language form to determine most accurately the user’s abilities. It is the same with the child with language impairment. The SLP determines those behaviors that are most characteristic of the child. These might be behaviors at a particular stage that the child uses most frequently or behaviors that represent the highest attainment level. The SLP must make this determination. All data from the two analysis methods—Assigning Structural Stage and Complex Sentence Development—are combined to place the child’s language form within a stage or stages of development and to describe the child’s language form. The child functioning well below age expectancy may need intervention.

Developmental Sentence Scoring Developmental Sentence Scoring, the process discussed in Developmental Sentence Analysis (L. Lee, 1974), is one of the most widely used and popular methods for assessing children’s syntactic and morphological development. Even so, DSS requires considerable study by the SLP to score language samples correctly. Although the instructions are explicit and straightforward, they require a thorough understanding of English syntax and morphology. Because the scale does not evaluate many aspects of children’s language, it should be only one aspect of an evaluation battery. In the following section I discuss the primary aspects of DSS and its most common problems. This survey cannot take the place of a thorough reading of DSS procedures and actual practice with the instrument. To rate a sample of child language, the SLP collects 50 different consecutive sentences. No speaker uses full sentences all the time. Therefore, utterances that do not qualify as sentences simply are omitted, and the remainder is collected until 50 consecutive sentences are amassed. DSS analysis should not be undertaken if less than 50 percent of the child’s utterances are sentences. Because the sample should include 50 different consecutive sentences, repeated sentences are discarded unless some change occurs. Run-on sentences of several independent clauses joined by and are segmented so that no more than two independent clauses are joined. For example, the following runon should be divided as noted: [We went to the zoo, and I saw monkeys,] [(and) we had a picnic, and I ate a hot dog,] [(and) I fed pigeons, and we came home on the bus.]

422

Appendix B

TABLE B.1

Developmental Sentence Scoring Categories and Point Values

Score

Indefinite Pronouns or Noun Modifiers

Personal Pronouns

1

it, this, that

1st and 2nd person: I, me, my, mine, you, your(s)

2 early-developing

3rd person: he, him, his,

Main Verbs

A. Uninflected verb: I see you. B. C. coming.

Copula, is or ’s: It’s red. is + verb + ing: He is -s and -ed: plays, Five

A.

she, her, hers

Secondary Verbs

played

infinitives: Irregular past: ate,

saw

see) Copula: am, are, was,

B. I wanna see (want to C. I’m gonna see

were D. Auxiliary: am, are, was, were

3

A. no, some, more, all, lot(s), one(s), two (etc.), other(s), another B. something, somebody, someone

4

nothing, nobody, none, no one

A. Plurals: we, us, our(s), they, them, their B. these, those

(going to see) I gotta see (got to see) Lemme [to] see (let me [to] see) Let’s [to] play (let us [to] play) Noncomplementing infinitives: I stopped to play. I’m afraid to look. It’s hard to do that.

A. can, will, may + verb: may go B. Obligatory do + verb: don’t go

Participle, present or past: I see a boy running. I found the toy

The and at the beginning of each sentence (“[and] we had . . . , and] I fed . . .”) would not be scored. A sentence may have more than one and if the word does not link clauses, but rather is used for compound subjects, verbs, or objects, for example: Jorge, Maria, and Shanisa were throwing and kicking beach balls and soccer balls. Sentences that begin with a conjunction, such as “Because I falled down,” are included in the sample, but the conjunction itself should not be scored because it does not link clauses. Each sentence is rated on the basis of eight grammatical categories and assigned a score of 1 to 8 points in the applicable categories. The categories and point values are given in Table B.1. Each struc-

Language Analysis Methods

TABLE B.1

Continued

Score

Negatives

1

it, this, that + copula or auxiliary is, ’s, + not: It’s not mine. This is not a dog. That is not moving.

Conjunctions

Interrogative Reversals

Wh-Questions

Reversal of copula: Isn’t it red? Were they there?

2

A. who, what, what + noun: Who am I? What is he eating? What book are you reading? B. where, how many, how much, what . . . do, what . . . for: Where did it go? How much do you want? What is he doing? What is a hammer for?

3

4

423

and

can’t, don’t

Reversal of auxiliary be: Is he coming? Isn’t he coming? Was he going? Wasn’t he going?

ture demonstrated in the sentence is scored each time it occurs. For example, sentence 1 in Table B.2, “I don’t know what I like,” contains the word I twice. Therefore, the word receives a score of 1 twice under personal pronouns, in addition to other points. Sentences that would be acceptable mature forms are given an additional point called a sentence point. The sentence point should only be awarded when the sentence is syntactically and semantically correct by mature standards. The following would not receive a sentence point: Carol and me went to the store. Nobody didn’t go. I got six pencils in my desk.

424

Appendix B

TABLE B.1

Score

5

Continued

Indefinite Pronouns or Noun Modifiers

Personal Pronouns

Main Verbs

Secondary Verbs

A. Early infinitival complements with themselves differing subjects in kernels: I want you to come. Let him [to] see. B. Later infinitival complements: I had to go. I told him to go. I tried to go. He ought to go.

Reflexives: myself, yourself, himself, herself, itself,

C. Obligatory deletions: Make it [to] go. I’d better [to] go. D. Infinitive with whword: I know what to get. I know how to do it. 6

A. Wh- pronouns: who, which, whose, whom, what, that, how many, how much: I know who came. That’s what I said. B. Wh- word + infinitive: I know what to do. I know who(m) to take.

A. could, would, should, might + verb: might come, could be B. Obligatory does, did + verb C. Emphatic does, did + verb

In Table B.2, sentence 2, “What you like?” receives a score of 4; it does not receive a sentence point because it is not an acceptable mature sentence. Sentence 3, “I don’t know,” does receive the sentence point. Attempt markers and incomplete markers may be awarded for structures. An attempt marker—a line or hyphen in place of a score—is awarded when a structure is attempted but incorrect. Naturally, as in sentence 4, “He bes happy,” the sentence cannot receive a sentence point. Surface structures that are conversationally appropriate but incomplete receive the incomplete marker inc in place of a score. If the structure is conversationally acceptable, it receives a sentence point. For example, in the following exchange, the child’s response would receive an incomplete for the main verb, but would receive a sentence point.

Language Analysis Methods

TABLE B.1

Continued

Score

Negatives

Conjunctions

5

isn’t, won’t

A. but B. so, and so, so that C. or, if

6

425

because

Interrogative Reversals

Wh-Questions

when, how, how + adjective: When shall I come? How do you do it? How big is it?

A. Obligatory do, does, did: Do they run? Does it bite? Didn’t it hurt? B. Reversal of modal: Can you play? Won’t it hurt? Shall I sit down? C. Tag question: It’s fun, isn’t it? It isn’t fun, is it?

SLP: Who let the guinea pig out? Child: I didn’t. (I didn’t [let him out].) Attempt and incomplete markers are difficult to use and confusing for those not familiar with DSS. They do not affect the score and are meant to aid the SLP in deciding where to begin intervention. This decision can be made on the basis of other data. The point value of each sentence is totaled and added to the value for every other sentence. This overall total is divided by the number of sentences (usually 50) to yield a score. The SLP must remember that this value is a DSS score, not an MLU. The two values are very different.

426

Appendix B

TABLE B.1

Score

7

8

Continued

Indefinite Pronouns or Noun Modifiers

Personal Pronouns

A. any, anything, (his) own, one, oneself, anybody, anyone whichever, whoever, B. every, everything, whatever everybody, Take whatever you everyone like. C. both, few, many, each, several, most, least, much, next, first, last, second (etc.)

Main Verbs

Secondary Verbs

A. Passive with get, any tense Passive with be, any tense B. must, shall + verb: must come C. have + verb + en: I’ve eaten D. have got: I’ve got it.

Passive infinitival complement: With get: I have to get dressed. I don’t want to get hurt. With be: I want to be pulled. It’s going to be locked.

A. have been + verb + ing had been + verb + ing

Gerund: Swinging is fun. I like fishing. He started laughing.

B. modal + have + verb + -en: may have eaten C. modal + be + verb + -ing: could be playing D. Other auxiliary combinations: should have been sleeping

Language Analysis Methods

TABLE B.1

Continued

Score

Negatives

7

All other negatives A. Uncontracted negatives: I can not go. He has not gone. B. Pronoun-auxiliary or pronoun-copula contraction: I’m not coming. He’s not here. C. Auxiliary-negative or copula-negative contraction: He wasn’t going. He hasn’t been seen. It couldn’t be mine. They aren’t big.

8

427

Conjunctions

Interrogative Reversals

Wh-Questions

why, what if, how come, how about + gerund: Why are you crying? What if I won’t do it? How come he is crying? How about coming with me?

A. where, when, how, A. Reversal of auxiliary whose, which, which + while, whether (or have: Has he seen noun: not), till, until, you? Whose cat is that? unless, since, B. Reversal with two or Which book do you before, after, for, three auxiliaries: Has want? as, as + adjective he been eating? + as, as if, like, Couldn’t he have that, than: I know waited? Could he have where you are. been crying? Wouldn’t Don’t come till he have been going? I call. B. Obligatory deletions: I run faster than you [run]. I’m as big as a man [is big]. It looks like a dog [looks]. C. Elliptical deletions (score 0): That’s why [I took it]. I know how. [I can do it]. D. Wh- words + infinitive: I know how to do it.

Source: Lee, L. (1974). Developmental sentence analysis (pp. 134–135). Evanston, IL: Northwestern University Press. Copyright 1974 by Northwestern University. Reprinted with permission.

428

Appendix B

The SLP then applies the DSS score to a table of ages and scores to compare the child’s performance with that of other children at that age. Figure B.1 on page 430 shows the average scores (50th percentile) for each age and the scores for the 10th, 25th, 75th, and 90th percentiles. For example, an average score for a 4-year-old would be approximately 7.3. Only the highest 10 percent of 4-year-olds would receive a score of 9.0 (90th percentile). According to the instructions, children whose scores place them below the 10th percentile should be considered for therapy. Therefore, a 4-year-old who scores below 4.7 should be considered for therapy. An age equivalent for the child placing below the 10th percentile can be determined by noting the point at which the horizontal line for the child’s score crosses the diagonal 50th-percentile line. At this age, the child’s score is an average score. For example, the child aged 51⁄2 who receives an average score of 5.0 points is well below the 10th percentile for that age and needs intervention. The age equivalent would be found by following the 5.0 line to the left until it intersects the diagonal 50th-percentile line. This occurs at an age of 3 years. Thus, the child has received a score that would be expected at approximately 3 years of age. Age equivalence, if needed, can be found in the same way for children, such as those with mental retardation, who may exceed the age-norm ceiling of 61⁄2 years. Obviously, the percentile values are not relevant. Language delay in years can be determined by subtracting the age equivalent from the child’s chronological age. In the previous example, the child’s language delay is approximately 21⁄2 years. Although this value means little for the direction of therapy, it does provide a score for those people, such as administrators, who demand such data, and it can be used as an index of change over time. The same precautions for such statistics given in Chapter 3 apply. The most common problems encountered with DSS are associated with determination of grammatical units and with scoring (Lively, 1984). These problems are discussed briefly in the following section. Readers can refer to Lively (1984) and Hughes, Fey, and Long (1992) for a more thorough discussion. Scoring Adverbs as Indefinite Pronouns/Noun Modifiers. Words such as first, last, and everywhere that tell the manner or place of an action are adverbs (“Let’s do this first”) and should not be scored as indefinite pronoun/noun modifiers. In contrast, other words, especially numbers, should be scored when they do function as indefinite pronoun/noun modifiers, as in the following: Can I have one? I have two dolls. No one don’t like me. Personal Pronoun/wh- Conjunction/wh- Question Confusion Wh- words may be used as personal pronouns (score 6) or as conjunctions (score 8). The distinction can be clarified by remembering that a complete clause will follow the conjunction. I want the one that talks. He told us that we could shovel his driveway. I know what you want. What do you want?

(Pronoun, because “talks” is not a complete clause) (Conjunction, because “we could shovel his driveway” is a complete clause) (Pronoun, because “you want” is not a complete clause) (Wh- question)

TABLE B.2

Language Sample Analysis Using Developmental Sentence Scoring

Developmental sentence scoring form Name: D.O.B.: D.O.K.: C.A.: Personal Pronouns

Main Verbs

1,1,6

4,1

What you like?

1

1

I don’t know.

1

4

He bes happy.

2

inc

I want to go home.

1

1

Score:

I don’t know what I like. [[T app0btable02]]

Indefinite Pronouns

What’s that? I can’t go now.

Secondary Verbs

Negatives

4

Interrogative Reversals

WhQuestions

4

Sentence Point

Total

1

18

2

4

4

1

10 2

2

1 1

Conjunctions

1 4

2

1

5

1

5

1

10

430

Appendix B

14

13.78

90th percentile

12.43

75th percentile

13 12

11.66

11

10.91 10.49 10.06

10

9.43

9.19

9.10

9 7.85

8.11

8.04

8

7.30

7

6.64

6.97

5.98

6.01

6.03

6

3

10th percentile

If child age 5:6 scores 5, cross horizontally to 50% mark.

4.36

4.28 3.72

Further investigate

6.72

5 4

25th percentile

Consider for therapy

7.89

5.38

5.24

50th percentile

3.48

3.10 2.69 2.48

2

1.97

Child has score expected for 3:0

1 0 1-6

2-0

2-6

3-0

3-6

4-0

4-6

5-0

5-6

6-0

6-6

FIGURE B.1 DSS expected scores and ages. Source: Lee, L. (1974). Developmental sentence analysis. Evanston, IL: Northwestern University Press. Reprinted with permission.

Main Verbs All uninflected or unmarked verbs receive a score of 1. Regular and irregular inflected verbs receive some other score. I like ice cream. She likes ice cream. She ate ice cream.

app0bintable03]]

(Uninflected = 1) (Inflected = 2) (Inflected = 2)

Incorrect attempts, such as using got for have, receive an attempt score. The verb do as a main verb receives a 1 or 2. As an auxiliary, it receives a 4 if uninflected and a 6 if inflected. The modal auxiliary verbs can, will, and may are scored in the same manner. Do it for me. I did my homework.

(Uninflected main verb = 1) (Inflected main verb = 2)

Language Analysis Methods

I do like ice cream. I did like ice cream. He does like ice cream. I can swim. I could swim.

431

(Uninflected auxiliary = 4) (Inflected auxiliary = 6) (Inflected auxiliary = 6) (Uninflected modal = 4) (Inflected modal = 6)

In contrast, the modal auxiliaries must and shall are always scored as 7. The perfect tense forms of have + verb (-en) also receive a 7. All sentences with two or more auxiliaries, as in “He could have gone,” receive an 8. Passive sentences present a special case; SLPs should refer to L. Lee (1974). Compound sentences can be very difficult, especially if material is omitted. With compound verbs, each is scored. If the auxiliary is omitted, both verbs still should receive the full score. I was singing and dancing.

(The second “was” is omitted and understood, so each verb receives a score of 2.)

If, on the other hand, the main verb is omitted, only the complete form is scored and the other abbreviated or elliptical form receives an incomplete score. I did complete my lesson, but Carol didn’t.

(The second “did” receives an incomplete score, whereas the first received a 6.)

Secondary Verbs The chief error in this category is in identifying the infinitive. Often the signal word to is omitted. If the child uses gonna, wanna, gotta, lemme, or let’s, the infinitive is scored as 2. Other infinitives receive a 5 if the subject of the infinitive is different from the subject of the main verb. I wanna go. I want to go. I want her to go. Make the car (to) go.

(Score as 2) (Score as 2) (Different subjects = 5) (The subject is understood to be “you,” and car is “to go,” so score the infinitive as 5.)

The form be + verb (-en) in the present tense is scored as copula plus adjective unless the agentive prepositional is explicit. In the past form was/were + verb (-en), it is scored as passive as long as it makes sense when the agentive phrase is added. The door is broken. The glass is broken by the cat. The glass was broken (by the cat). The girl was lost.

(Score as 1) (Score as 7) (Score as 7) (Score as 2)

432

Appendix B

Negatives The only negative to receive a score of 1 is the this/that/it + is/’s not form. All other forms of this combination receive a higher score. Any other subject or auxiliary verb receives a score of 7. It is not yours. It’s not yours. It isn’t yours. You can’t do it.

(“It is not” = 1) (“It’s not” = 1) (“It isn’t” = 5) (“Can’t” = 7)

Conjunctions Score the conjunction then as 3 for and then, even though the and is omitted, as long as two independent clauses are joined. Interrogative Reversals SLPs often overlook interrogative reversals when scoring wh- questions. Tag questions, except those ending in huh, okay, eh, and the like, receive a score of 6. Sentence Point If the child has been interrupted in mid-sentence but has produced the subject and the predicate of the sentence and this stem is grammatically acceptable, the partial sentence should be scored and given a sentence point. Obviously, Developmental Sentence Scoring is a very complex analysis system, not to be attempted without a thorough knowledge of both English syntax and DSS procedures. Unfortunately, the child’s score offers little direction for intervention, although Lee suggests appropriate places at which to begin intervention based primarily on the percentage of correct production. The hierarchy presented in Table B.1 offers only limited guidance and omits many important structures. This type of problem seems inherent in any analysis system that reduces complex behavior to point values. MODI FICATION FOR CLD CH I LDR E N The nature of the DSS makes it an inappropriate tool to use for assessing the language abilities of CLD children. Some advances have been made in this area. Black English Sentence Scoring (BESS) is a promising attempt to maintain the DSS format while measuring African American English usage. The scoring criteria, a sample scoring, and means and standard deviations are listed in Tables B.3, B.4, and B.5 respectively. SU M MARY DSS is a good quantitative measure, although no data are available on the relationship of DSS scores to the type and extent of a child’s LI (Hughes et al., 1992). Even when matched with peers on the basis of MLU, children with LI tend to have more difficulty with the main verb and pronoun categories and may have difficulty with secondary verbs, negatives, and conjunctions. DSS has shown great resiliency and has been modified for speakers of Black English, expanded to 6- to 10-year-olds, and converted to a computerized version (Hughes, Low, Fey, & Alsop, 1990; Long & Fey, 1991; N. Nelson & Hyter, 1990; Stephens, Dallman, & Montgomery, 1988). Although DSS scoring has been computerized in a variant of SALT transcription called Computerized Profiling (Long, Fey, & Channell, 2000), reliability comparisons with hand-scored DSS suggest further refinement of the program may be needed (Channell, 2003).

Language Analysis Methods

433

Systematic Analysis of Language Transcripts Systematic Analysis of Language Transcripts (SALT for Windows, Version 6.1) (J. Miller & Chapman, 2003) is one of the most promising computer analysis methods available. Based on Assigning Structural Stage/Complex Sentence Development (J. Miller, 1981), SALT is designed for use with the IBM PCs and Macintosh computers. Within limits, SALT analyzes morphemic, syntactic, and semantic aspects of a language sample. The transcript is typed in standard English orthography. Time is critical for calculation of duration and pause times and must be noted. Each feature to be analyzed is signaled with a different marker. Therefore, it takes approximately 7 minutes for even the skilled user to enter each minute of conversation into the transcription format. The SLP can accomplish several types of analyses by using SALT. These types include utterance type; turn overlap and distribution; pause duration and number; utterances per minute and words per utterance; frequency of verbal and nonverbal data of interest, such as past tense; utterance length; typetoken ratio; MLU; Brown’s stages of development; expected age range of development; word and category lists; and other user-designated analysis. CONCLUSION SALT is a very promising and versatile analysis method that is easy for the SLP to use after becoming familiar with entering the transcript into the computer. As with other computer analysis methods, however, it is not the great panacea. At present, most results are a calculation of those features signaled by the SLP when he or she enters the data. Thus, special care is required to ensure that features are signaled accurately.

434

Appendix B

TABLE B.3

Black English Sentence Scoring Categories and Point Values

Indefinite Pronouns or Noun Modifiers

1

T[app0batbel03]

• these/this: these many

2

3

• no (when 2nd or 3rd neg. marker): He don’t like me no more.

Personal Pronouns

Main Verbs

• mine’s/my, you/your: That you book? • y’all (plural you) • me/I (in compound subj.): Me and my brother went in it.

• φ copula is, am, are: That boy my friend. Or hypercorrect: I’m is six. • φ aux. be + -ing: The girl singin’. • Locational go or existential it’s: Here go some lights. It’s two dimes stuck on the table. • got as uninflected have: You gotta take it home.

• he, she (in apposition): My brother, he bigger than you. • they/he: They my uncle. • he, he’s/his: He’s name is Terry. • she, she’s/her

• Third-person singular and regular past tense markers deleted • have/has: It have money on it. • Regularization of -s and -ed: Trudy and my sister hides. (hypercorrect) • Aux. was/were: We was gon’ rob some money. • Irreg. past tense–Uninflected: He find the money. Past form as participle: We have went. Participle as past form: He done it first.

• we, they (in apposition): The boys, they got in trouble. • they/their: They name is Tanya and Bryan. • them/they or their: I know what them is. One of ’em name is Caesar. • them/those: them kids

Secondary Verbs

• I’m, I’mon, I’ma pronunciation of I’m gonna + V: I’m play. I’ma be tired. • go pronunciation of gonna: His nose go bleed. • fixin’ to (used like gonna): I’m fixin’ to take him to jail.

Language Analysis Methods

TABLE B.3

Continued

Negatives

1

435

Conjunctions

• it, this, that + φ copula/aux. + not/ain’t: That not mine. It ain’t on?

Interrogative Reversal

Wh- Questions

• rising intonation with deleted or unreversed copula: You my friend? Where the gas at? What this is? • is/are: Derrick, is you?

• who, what, what + noun (with deleted aux. or copula) • where, how many, how much, what . . . do, what . . . for (with deleted aux. or copula): Where the man? • wh- Qs formed without interrogative reversal: What that is?

2

3

• and plus • φ and (when intonation makes sentence combination clear): He pointed his finger at him (with rising intonation); he pointed his finger at him (with falling intonation).

436

Appendix B

TABLE B.3

Continued

Indefinite Pronouns or Noun Modifiers

4

Personal Pronouns

• nothing, nobody, none, no one (when 2nd or 3rd neg. marker): Ain’t nobody got none.

5

• personal datives me, him, her: I’m gonna buy me some candy. He make him a lot of ’em. • reflexives: hisself, theirselves, themself, theyselves.

6

• what (in apposition): My voice gonna come out of here what I said on that book? • what/that or who: He’s the one what I told you about. • Deleted relative pronoun: I saw a little girl was on the street.

Main Verbs

Secondary Verbs

• φ modal will or ’ll: I be five when my birthday come. • don’t + verb (3rd pers. sing.): My mama, she don’t like it. • do uninflected: Do he still have it? (Score inc. in My sister do.) • φ do in Qs: You still have it? • ain’t (as copula or aux.): Ain’t no dirt in it. Nobody ain’t got no more. • can’t, don’t, won’t as preposed neg. aux.: Can’t nobody do it. • could/can: He could climb that tree.

• Participal with deleted -en: I found the toy broke. (morphological difference)

• deleted to in infinitival complements: My grandma tell me stay away from him. I like go shopping. My mommy used do it.

• did + -n’t + verb (when 2nd or 3rd neg. marker: Nobody didn’t do it. • could, would, should + -n’t + verb (preposed neg. aux.): Couldn’t nobody do it. • φ contracted could or would (phonol. deletions): You(’d) burn your head off. • might/will: Who might be the baby?

Language Analysis Methods

TABLE B.3

Continued

Negatives

4

437

Conjunctions

Interrogative Reversal

Wh- Questions

• φ auxiliary be: My voice gonna come out of here? You gonna tell my mama?

• don’t (with 3rd pers. sing. as 2nd or 3rd neg. marker): He don’t want none. No, nobody don’t live with me.

• was/were: Was you throwin’ rocks?

• can’t, don’t (as preposed aux.): Can’t nobody make me. • φ copula/aux. + not + V: My mama not gonna pick me up today. He not a baby. • ain’t (as negative copula or aux. be): He ain’t my friend. 5

6

• won’t (as preposed aux.): Won’t nobody help him.

• when, how (with deleted aux., copula, or do): How you do this?

• for/so: The dog make too much noise for they won’t catch many fish. • conditional and: You do that and I’m gonna smack you. • if with phrase deletions: He lookin’ if he see the money. • aux. inversion in indirect Qs (instead of if): She ask me do he want some more. • or either, or neither (as disjunctives): He will go or either he will stay. He told her that he wouldn’t be bad or neither get in trouble. • preposed why phrase (with because): Why he’s in here, cause baby scared the dog.

• φ do: You know that one with the tractor? Where you work? You got blue eyes? • do (with 3rd pers. sing.) Do he still have it? • φ or unreversed modal: Now, what else I be doin? Why you can’t talk on that? • Tag question with ain’t: It gonna be fun, ain’t it?

438

Appendix B

TABLE B.3

Continued

Indefinite Pronouns or Noun Modifiers

7

8

• many a: Many a people likes to give him a nickel

Personal Pronouns

Main Verbs

Secondary Verbs

• passive verb + en with getting (aux deleted): Leroy getting dressed. • passive verb ± be ± en: One is name Brick. They named Chief and JoJo. • done + verb + en (completive aspect): I done tried. • ± (neg.) aux. + supposed: He don’t supposed to do it. What toy you supposed to play with? • ± have ± verb ± en: We seen him already. He have made him mad.

• passive with phonological deletions: I’m be dressed up real cute. I’ma be tired. She gonna be surprise, ain’t she? I want it cut on.

• invariant be: My daddy know I skip school ’cause I be home with him. He be mad when somebody leave him home. • double modals: We might could come. • other expanded aux forms: He be done jumped out the tub. He been going. (have has undergone phonological deletion) You shouldn’t did that. • remote past aspect: She been whuptin’ the baby. I been wanted this.

• gerund with go to, got to, start to: When I cry, she goes to whipping me. He started to crying. He got to thinking.

Language Analysis Methods

TABLE B.3

Continued

Negatives

7

8

439

Conjunctions

Interrogative Reversal

• ain’t (for have + not) ± uninflected V: I ain’t taste any. • ain’t (for did + not) ± uninflected V: Yesterday, he ain’t go to school. I ain’t found Marge in the school. • couldn’t, wouldn’t, shouldn’t (as preposed aux) • wasn’t/weren’t: The brakes wasn’t workin’ right. • weren’t/wasn’t: There weren’t no money. • uncontracted, uninflected neg. aux.: Lester do not like it.

Wh- Questions

• why, what if, how come (with deleted or unreversed aux. copula or do, or with got): Why she turn that way? Hey, why you got a dress on mama?

• less’n (for unless) • to/till: I didn’t get to sleep to I had to come in the morning. • ± as + adjective + as: He sock Leroy in the arm hard as he could.

• deleted have: He seen it? How you been? What you been doing? • have with 3rd pers. sing.: Have he seen you?

• whose, which, which + noun (with deleted aux. copula or do) • who/whose: Who this bed? Who baby is that?

Source: Nelson, N. W., & Hyter, Y. D. (1990). Black English Sentence Scoring: Development and Use as a tool for nonbiased assessment. Unpublished manuscript. Western Michigan University, Kalamazoo. Copyright 1990 by N. W. Nelson. Reprinted by permission.

TABLE B.4

Language Sample Analysis Using Black English Sentence Scoring

Name

Eric

Age

4:0

Date

May 31, 1993

DSS

3.73

Indef. Pron.

1. That the food that grandma ate.

1

2. I goin’ to nursery school.

BESS Pers. Pron.

6 1

3. I putting my sister on a motorcycle.

1, 1

4. I listening.

1

6.55 Prim. Verb

Sec. Verb

Neg.

Conj.

Inter. Rev.

WhQues.

Sent. Point

Total c

1 –, 2

11b

1

a

0

9

1 –

1 0

3

1 –

0

1 –

0

1

1 1

4 2

1

3

5. I watched him yesterday.

1, 2

2

1

6

6. I like these.

1, 3

1

1

6

1, 3

4 –

0

7. I push all these buttons, ok?

3

8. They try catch me.

3, 1

9. I had a spoon. 10. Who this on the phone? 11. Where the gun?

1

2 –

1 5 –

12 7

1

12

0

4

1

4

1

2

1 –

1 –

1 –

2 –

0

1 –

1 –

1 –

2 –

0

1

6 1

1

5 0

Total DSS for this partial sample: 41 divided by 11 = 3.73 Total BESS for this partial sample: 72 divided by 11 = 6.55 a Sentence total for DSS. b Sentence total for BESS. c Point earned for BESS but not DSS. (Numbers above DSS attempt markers (—) represent credit awarded for BESS but not DSS.)

Source: Nelson, N. W., & Hyter, Y. D. (1990). Black English sentence scoring: Development and and use as a tool for nonbiased assessment. Unpublished manuscript. Western Michigan University, Kalamazoo. Reprinted by permission.

Language Analysis Methods

TABLE B.5

441

Means and Standard Deviations for DSS and BESS

Age Range

N

Mean DSS

SD

3:0-3:6

8

5.63

0.91

7.44

1.15

3:6-4:0

8

5.73

1.04

7.71

0.98

4:0-4:6

8

7.47

1.58

9.33

1.26

4:6-5:0

8

7.51

1.68

8.85

1.48

5:0-5:6

8

8.86

1.93

10.79

1.92

5:6-6:0 6:0-6:6

8 8

8.31 9.12

2.04 2.43

10.02 11.08

2.16 1.61

6:6-7:0

8

9.47

1.72

11.17

2.17

T[app0batbel05]

Mean BESS

SD

Source: Nelson, N. W., & Hyter, Y.D. (1990). Black English Sentence Scoring: Development and and use as a tool for nonbiased assessment. Unpublished manuscript. Western Michigan University, Kalamazoo. Reprinted by permission.

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Appendix

C

Selected English Morphological Prefixes and Suffixes

443

444

Appendix C

TABLE C.1

Prefixes and Suffixes Derivational

Prefixes

Suffixes

a- (in, on, into, in a manner)

-able (ability, tendency, likelihood)

Inflectional

-ed (past)

bi- (twice, two)

-al (pertaining to, like, action, process)

-ing (at present)

de- (negative, descent, reversal)

-ance (action, state)

-s (plural)

ex- (out of, from, thoroughly)

-ation (denoting action in a noun)

-s (third person marker)

inter- (reciprocal between, together)

-en (used to form verbs from adjectives)

-’s (possession)

mis- (ill, negative, wrong)

-ence (action, state)

out- (extra, beyond, not)

-er (used as an agentive ending)

over- (over)

-est (superlative)

post- (behind, after)

-ful (full, tending)

pre- (to, before)

-ible (ability, tendency, likelihood)

pro- (in favor of)

-ish (belonging to)

re- (again, backward motion)

-ism (doctrine, state, practice)

semi- (half)

-ist (one who does something)

super- (superior)

-ity (used for abstract nouns)

trans- (across, beyond)

-ive (tendency or connection)

tri- (three)

-ize (action, policy)

un- (not, reversal)

-less (without)

under- (under)

-ly (used to form adverbs) -ment (action, product, means, state) -ness (quality, state) -or (used as an agentive ending) -ous (full of, having, like) -y (inclined to)

Appendix

D

Indirect Elicitation Techniques

445

446

Appendix D

T

here is an infinite variety of indirect elicitation techniques, although we tend to rely on two old favorites:

Tell me what you see. Tell me in a whole sentence. Here are a few conversational techniques that came to mind one day. The list is not exhaustive, merely illustrative. TABLE D.1

Indirect Elicitation Techniques

Technique

Target

Example

The emperor’s new clothes

Negative statements

CLINICIAN: Oh, Shirley, what beautiful yellow boots!

Pass it on

Requests for information

CLINICIAN: John, do you know where Linda’s project is?

CHILD: I’m not wearing boots! CHILD: No. CLINICIAN: Oh, see if she knows?

Violating routines (“Silly rabbit”)

Imperatives, directives

CHILD: Linda, where’s your project? CLINICIAN: Here’s your sandwich. CHILD: Nothing in it. CLINICIAN: Oh, you must like different sandwiches than I do. What do you want? CHILD: Peanut butter. CLINICIAN: How do I do it? (There’s your opener)

Nonblabbermouth

Requests for information

CLINICIAN: (Place interesting object in front of child) “Boy, is this neat.” CHILD: What is it? CLINICIAN: A flibbideejibbit. (Now STOP. Don’t give any more info)

What I have

Request for action

Guess what I did

Request for information, past tense verbs

Mumble

Contingent query

CHILD: What’s it do? CLINICIAN: Oh, I can’t wait to show you what I have in this bag. It’s really neat. (Wait child out) CLINICIAN: Guess what I did yesterday in the park. CHILD: Jogged? Picked flowers? Had a picnic? At height of an interesting story or punchline of a joke, clinician should mumble so that child does not receive message. If needed, increase pressure by asking questions on what was just said.

Indirect Elicitation Techniques

TABLE D.1

447

continued

Technique

Ask someone else

Target

Request for information

Example

CLINICIAN: What do you need? CHILD: Sugar. CLINICIAN: I don’t know where it is. Why don’t you ask Sally where the sugar is?

Rule giving

Requests for objects

CLINICIAN: I have the athletic equipment for recess. If you need some, just ask me. CHILD: I want jump rope.

Request for assistance

Initiating conversation

CLINICIAN: John, can you ask Keith to help me?

Modeling with meaningful intent

I want _____

CLINICIAN: We have lots of colored paper for our project. Now let’s see who needs some. I want a green one. (Take one and wait) CHILD: I want blue.

“Screw up” #1

Locatives, prepositions

CLINICIAN: Can you help me dress this doll? (Place shoe on doll’s head) How’s that? CHILD: No. The shoe goes on the doll’s foot. CLINICIAN: But now the foot’s all gone. CHILD: No. It’s in the shoe.

“Screw up” #2

Negative statements

CLINICIAN: Here’s your snack. (Give child a pencil) CHILD: That’s not a snack.

Requests for topic

Statements

CLINICIAN: Now let’s talk about your birthday party. (Not shared information)

Expansion of child utterance into desired form

Infinitives

CHILD: I want paste crayon. CLINICIAN: You want crayon to sing with? CHILD: No, to color. CLINICIAN: What? CHILD: I want crayon to color.

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Appendix

E

Intervention Activities and Language Targets

449

FIGURE E.1 Activities and targets.

Barrier tasks Body tracing Colorforms *Cooking Describing pictures that others cannot see Dolls, clothing, and furniture Dressing Dress-up Explaining “how-to” Farm or zoo play Guiding others through an activity Treasure Hunt—“You’re getting warmer” Interviewing “I see something that’s ...” Jeopardy Kitchen play

X X X X X X X X X X X X X X X X X X X X X X X X X X X X X X X X X X X X X X X X X X X X X X X X X X X X X X X X X X X X X X X X X

X X

X

Vocabulary

Word association

Auditory processing and memory

Variety of pragmatic features

Conversational repair

Presupposition

Register

Categorization

Turn taking

Sequencing

Giving directions

Following directions

Interrogatives

Negatives

Requests for information

Requests for assistance

Requests for objects

Prepositions/spatial terms

Articles and/or demonstrations

Pronouns

Adverbs

Adjectives/descriptive words

Verb tensing

Plurals

Bot to Au Arti mic dito Adj cle intr Vari ry ecti s Pre Re odu ety pro ves and pos Re Re que ctio Co of ces /de /or itio que que sts Foll n nve pra sin Wor Ver scri de ns/ sts sts for owi Givi and Pre rsat gm g d b ptiv mo spa for for info Inte ng ng Se Tur mai Cat sup ion atic and ass ten e Adv Pro nstr tial obj ass rm Ne rro dire dire que n nte ego Re pos al feat me oci Voc No Plu sin wor erb nou atio ter ect ista atio gati gati ctio ctio nci taki nan riza gist itio rep ure mo atio abu uns rals g ds s ns ns ms s nce n ves ves ns ns ng ng ce tion er n air s ry n lary Nouns

Activities

Topic introduction and maintenance

Targets

X X

X

X X X

X

X X

X

X

X

X X X

X

X X

X X X X

X X X

X X

X

X

Targets

*Making things Map following Mime My “ME” book Music and action songs Nature or science activity Obstacle course Planning an activity Planting seeds Playhouse Playing teacher Pretend shopping Puppet show Putting objects in order “Safety Town” (Safety curriculum for preschool and kindergarten) Simon Says Simulated restaurant Sorting clothing Storytelling (true or make-believe) Telephone play TV commercials “Twenty questions” variations Washing dishes “What am I?” “What did you do ...?” *See third page of table (p. 452)

X

X X X X X X X X X X X X X X X X X X X X X X X X X X X X X X X X X X X X X X X X X X X X X X X X X X X X X X X X X X X X X X X

X X X

X

X X

X X X

X X X

X X X X

X

X

X X

X

X

X X

X X X X X X X X X X X X X X X

X X

X

X

X X X X

X

X X X X X

X X X

X X X X

X

X X X

X X X X X X X X X X X X X X X X X X X X X X X X X X X

X X X

X

X X X

X

X X X X

X X

X X X X X X X X X X X

X X

X

452

Appendix E

FIGURE E.1 Continued Possible cooking activities: Be sure to check for possible allergies or sensitivities to nuts and milk before using these items. 1. Cookies, cupcakes, muffins 2. Cornbread and butter 3. Edible honeybees—Mix 1/2 cup peanut butter, 1 T. plus 1/3 cup honey, 2 T. sesame seeds, and 2 T. toasted wheat germ. Roll into balls. Make stripes on the bee by dipping a toothpick in cocoa powder and pressing into ball. Use slivered almonds for wings. 4. English muffin pizzas 5. Fruit salad—Use a few vegetables just to confuse the issue and to elicit some language. 6. Ice cream sundaes 7. Instant pudding 8. Milkshakes—Lots of variations here, such as vanilla, chocolate, and banana (use real ones in the blender). 9. Peanut butter and jelly sandwiches. 10. Peanut butter balls—Mix 1/2 cup honey, 1/2 cup peanut butter, 1 cup dry milk, and 1 cup oatmeal. Roll into balls. Refrigerate. 11. Peanut butter “face” sandwiches—Make faces on the bread with a peanut butter base using raisins (eyes), peanut (nose), chocolate chips (mouth), and carrot slivers or coconut (hair). 12. Picnic lunch 13. Popcorn and popcorn balls **Things to make: 1. Cereal box instrument—Use a strong cereal box with a circular hole cut in the face similar to the hole in a guitar. Stretch various size rubber bands around the box and tack them into wooden blocks that act as bridges. 2. Costumes from grocery bags—Cut eye holes or a hole for face. Cut arm holes if desired. Decorate bag. Slip over child. 3. Cowgirl and cowboy outfits from grocery bags—Bags can easily be cut to resemble vests and yokes. Be sure to fringe them. Add a bandanna and you have the outfit. 4. Decorate a shoebox “room” with scraps of wallpaper. 5. Food sculptures—Use shredded coconut or lettuce, raisins, peanuts, M&Ms, hot cinnamon candies, cheese strips, fruit halves, celery and carrot sticks, olives, marshmallows, gum drops, and toothpicks. 6. Holiday cards 7. Kites 8. Paper bag puppets 9. Paper butterflies 10. Paper flowers 11. Playdough—Mix 2 cups flour, 1 cup water, 1 T. salad oil, 1 cup salt, and food coloring. 12. Potato and sponge prints 13. Sachets—Cloves and crumbled bay leaves and cinnamon sticks in square of cloth. Pull ends of cloth together and tie with a ribbon. 14. Snowmen and snowwomen—Use styrofoam balls, pipecleaners, cloves, and toothpicks. 15. Stained glass windows—Cut out a cardboard mold. Tape aluminum foil over one side of the cut-out sections. Place this side down. Fill the holes with Elmer’s glue. Swirl in food coloring. Allow to dry thoroughly. Peel foil. Hang in sunny window.. Note: A variety of language features can be elicited within these activities by using the indirect elicitation techniques in Appendix D and the nonlinguistic strategies in Chapter 10.

Appendix

F

Use of Children’s Literature in Preschool Classrooms

453

454

Appendix F

Book

Language Use

Aardema, Oh, Kojo! How could you! (M) Aardema, Bring the rain to Kapiti Plain (M) Adler, Bunny Rabbit Rebus Agee, Flapsticks Ahlberg, Jolly postman Ahlberg, Each peach pear plum

Predicting, cause and effect

Albert, Where does the trail lead? Alborough, Where’s my teddy? Allard, Miss Nelson has a field day Allard, Miss Nelson is missing Allard, Miss Nelson is back Allard, The Stupids die Allard, The Stupids have a ball Allard, The Stupids step out Allen, A lion in the night Allen, Who sank the boat? Anholt & Anholt, Here come the babies Anno, Anno’s counting house Appelt, Elephants aloft Arnold, Green Wilma Arnold, The simple people Asch, Just like daddy (Surprise ending) Asch, The last puppy Ash, Little fish, big fish (Visual interest) Avery, Everybody has feelings (Todos tenemos sentimientos) (M) Aylesworth, The good night kiss

Rhyming, predicting, past tense, plosives, chanting Word play Rhyming Predicting Rhyming, predicting, visual discrimination, “I spy” with prepositions Predicting, chanting

Theme

WEATHER

SENSES

Rhyming Predicting, cause and effect, emotions Predicting, cause and effect, reasoning Predicting, cause and effect Verbal absurdities Verbal absurdities Verbal absurdities Predicting, present progressive ANIMALS and future tense, sequencing Predicting, chanting, interrogative TRANSPORTATION structures Rhyming, naming, /b/ words Numbers, counting, observational skills Locative prepositions Past tense, noticing the ridiculous Past tense, /s/ words, emotions Chanting

COUNTING

First/last Big/little contrast

ANIMALS

Emotions, discussion

FEELINGS

Predicting, fill-ins

BEDTIME

ANIMALS

FEELINGS FAMILY

Use of Children’s Literature in Preschool Classrooms

Book

Language Use

Aylesworth, The old black fly (A little grim) Baer, Thump, thump, rat-a-tattat Bang, Ten, nine, eight (M) Baker, Hide and Snake

Creative alphabet, chanting, initial COLORS / ʃ/ words Chanting, making sounds

Baker, The third-story cat Baker, White rabbit’s coloring book Banchek, Snake in, snake out Barret, Animals should definitely not act like people Barrett, Cloudy with a chance of meatballs Barton, Airplanes Barton, Airport

Barton, Boats

Barton, Harry is a scaredy-cat

Bennett & Cooke, One cow moo moo Berger, Grandfather Twilight Borden, Caps, hats, socks, and mittens Boyd, Black dog, red house Boynton, A is for angry Brown, A dark dark tale Brown, Arthur’s nose Brown, Big red barn Brown, Goodnight moon Brown, If at first you do not see Brown, The noise book

Counting, rhyming Observational skills, elicited descriptions Prepositions, past tense Adjectives, predicting

Theme

COUNTING

ANIMALS COLORS

Prepositions Word play, illiteration, absurdity Metaphors, if/then conditional sentences, “s” words, humor Vocabulary, noun-verb agreement, categories Vocabulary, noun-verb agreement, categories, relating experiences Vocabulary, noun-verb agreement, categories, relating experiences Present progressive tense, initial /k/ words, /sk/ blends, discussion Chanting, auditory memory

WEATHER

Final consonants, night vs. day Final /ts, ps/ blends

BEDTIME AUTUMN

Colors Alphabet with animals and adjectives Sequencing, prepositions, adjectives Possessive /-’s/ marker, pronouns Initial /r/ words Predicting, noun-verb agreement, plurals Observation, imaginative language Auditory discrimination

COLORS

TRANSPORTATION TRANSPORTATION

TRANSPORTATION

FEELINGS

ANIMALS, COUNTING

SENSE ANIMALS BEDTIME FEELINGS SENSES

455

456

Appendix F

Book

Language Use

Theme

Brown, Old MacDonald had a farm Brown, The runaway bunny

Singing, /f/ words

ANIMALS

Buckley & Carle, The foolish tortoise Burningham, Hey! Get off our train Burningham, Jingle, twang Burningham, Mr. Gumpy’s outing Burningham, Skip, trip Burningham, Sniff, shout Burningham, Would you rather? Butterworth & Inkpen, Nice or nasty: A book of opposites Byars, Go and hush the baby Calmenson, It begins with an A Capucilli, Inside a barn in the country Carle, The grouchy ladybug Carle, A house for a hermit crab Carle, The secret birthday message Carle, The tiny seed Carle, The very busy spider Carle, The very hungry caterpillar Carle, The very quiet cricket Carlson, I like me Carlstrom, Goodbye geese Carlstrom, How do you say it today, Jesse Bear? Cauley, Goldilocks and the three bears Cauley, Jack and the beanstalk Charles, What am I?

Prepositions, pronouns, present ANIMALS progressive tense Sequencing, discussion (“Why it’s SELF-ESTEEM good to be me”) Chanting TRANSPORTATION Present progressive tense, word play Predicting, narratives and TRANSPORTATION interrogatives Verb vocabulary, use to elicit SVO structures Verb vocabulary, use to elicit SVO structures Basis for why not discussions ANIMALS Antonyms Predicting Initial sounds, auditory attending, and synthesis, word play Chanting, /s/ blends Pragmatics, emotions, chanting Initial /s/ and /s/ blends Word play, prepositions, vocabulary Sequencing Predicting, initial /sp/ blends, initial /v/ words Sequencing, auditory memory, present progressive tense Predicting, initial /kw, k/ blends, initial /s/ words Final /k/ words, initial /l/ words Body parts General speech, chanting, seasons Predicting Predicting Colors, visual recognition, question-answer

ANIMALS

BIRTHDAY SEASONS

SENSES

SELF-ESTEEM WINTER MANNERS ANIMALS

COLORS

Use of Children’s Literature in Preschool Classrooms

Book

Charlip, Fortunately

Language Use

Predicting emotions, past tense, adverbs, initial /f/ words Cheltenham, Kindergarteners, we Descriptors, same/different are all alike . . . we are all discussion different (M) Chorao, Kate’s box Pronouns, possessive /-’s/ marker, prepositions, present progressive and past tense Christelow, Five little monkeys Chanting, counting, initial /l/ jumping on the bed words Cole, Monster manners Pragmatic past tense Collington, The midnight circus Sequencing, describing, cohesion Corey, Everyone takes turns Pragmatics Crews, Freight trains Blends, colors, two-word semantic rules Dabkovich, Sleepy bear Predicting, verb tensing Davol, Black, white, just right (M) Descriptors, verb person markers Day, Good dog, Carl Sequencing, narratives, descriptors Day, Carl goes to daycare Sequencing, narratives, descriptors Day, Carl goes shopping Sequencing, narratives, descriptors Day, Carl’s afternoon in the park Sequencing, narratives, descriptors Deming, Who is tapping at my Chanting, rhyming window? DePaola, Charlie needs a cloak Sequencing, vocabulary (words defined at end), past tense DePaola, I love you, mouse Imagining, if . . . then DePaola, The knight and the Present progressive and past dragon tense, vocabulary DePaola, Pancakes for Predicting, storytelling, breakfast sequencing, present progressive tense, final /k/ words deRegniers, Going for a walk Chanting, rhyming, predicting deRegniers, It does not say Auditory attending and meow processing, adjectives, problem solving Dunrea, Deep down Chanting, counting, initial /g, s, b, underground r, d/ words Ehlert, Planting a rainbow Initial /r/ words

Theme

BIRTHDAY, FEELINGS SELF-ESTEEM

COUNTING MANNERS

MANNERS TRANSPORTATION, COLORS BEDTIME SELF-ESTEEM

COMMUNITY COMMUNITY COMMUNITY

CLOTHES ANIMALS, FEELING

SENSES

FEELINGS ANIMALS

ANIMALS, COUNTING COLORS

457

458

Appendix F

Book

Language Use

Theme

Ehlert, Red leaf, yellow leaf

Regular plurals, regular past, seasons Predicting, chanting

AUTUMN, COLORS

Singular/plural contrasts, present progressive and past tense Past tense, discussion Chanting, predicting Predicting, past tense Final /ʃ/ words Predicting, chanting, auditory memory Predicting, chanting, rhyming Predicting Predicting Initial /t/ words, fill-ins Initial /g/ words

ANIMALS

Initial /g/ words Present progressive tense, chanting, acting out Sequencing, narrating, descriptors Regular plural, possessive -’s, third-person -s Sequencing, narrating, descriptors Past tense, chanting, predicting, demonstratives (this, that) Imagining, descriptors Chanting, predicting

MANNERS ANIMALS, FEELINGS

Emberley, Go away, big green monster Ets, In the forest Ets, Play with me Evans, Hunky Dory found it Everitt, Frida the wondercat Fleming, In the tall, tall grass Fox, Hattie and the fox Fox, Shoes from grandpa Ga’g, Millions of cats Galdone, Henny penny Galdone, The teeny-tiny woman Galdone, The three billy goats gruff Gantos, Greedy greeny Gelman, I went to the zoo Geisert, Oink, oink Gibbons, The season of Arnold’s apple tree Gill, The spring hat Ginsburg, Good morning, Chick Glassman, The wizard next door Goffe, Ma, you’re driving me crazy Goode, Where’s our mama? Graham, Full moon soup or the fall of the Hotel Splendide Graham, I love you mouse Guarino, Is your mama a llama? Guarino, Tu mama es una llama? Grindley, Knock, knock! Who’s there? Gwynne, A chocolate moose for dinner

FEELINGS

ANIMALS ANIMALS ANIMALS ANIMALS CLOTHES ANIMALS ANIMALS ANIMALS

ANIMALS AUTUMN, WINTER, SPRING CLOTHES, SPRING ANIMALS

FEELINGS

Chanting, questions-answers in unison Narrating, observing, descriptors, questioning, answering Predicting, chanting Guessing, chanting, descriptors Guessing, chanting, descriptors

ANIMALS, FEELINGS ANIMALS, FAMILY ANIMALS, FAMILY

Questioning, chanting, if-then

FAMILY

Figurative language, absurdities

Use of Children’s Literature in Preschool Classrooms

Book

Language Use

Gwynne, A king who rained Hale, Mary had a little lamb Hayes, The grumpalump

Figurative language, absurdities Initial /l/ words Chanting, auditory memory, past tense Prereading skills Prereading skills

Hempworth, Antics Henck, Pony and bear are friends Henrietta, A mouse in the house Hill, Spot’s birthday party Hines, Daddy makes the best spaghetti Hines, It’s just me, Emily Hoban, Exactly the opposite Hoban, Is it rough, is it smooth, is it shiny? Hoban, Is it larger? Is it smaller?

Hudson, Jamal’s busy day (M) Hudson & Ford, Bright eyes, brown skin (M) Hutchins, Don’t forget the bacon Hutchins, The doorbell rang

Hutchins, Goodnight owl Hutchins, I hunter Hutchins, Rosie’s walk Hutchins, The surprise party Hutchins, The very worst monster Janovitz, Look out, bird Johnson, The girl who wore snakes (M) Johnson, When I am old with you (M) Johnson, Never babysit the hippopotamuses Jonas, Reflections

Observing Prepositions Sequencing, relating experiences Predicting, chanting Descriptors, opposites Adjectives, antonyms Singular/plural contrast (regular and irregular), descriptors, comparative Discussion (importance of school) Descriptors Auditory memory, word play, initial /f/ words, chanting Predicting, conversational skills, simple practical math, initial /g, k, r/ words Predicting, chanting, regular past tense Observing, counting Prepositions, present progressive and past tense, sequencing Predicting, auditory memory Present progressive, adjectives

Theme

ANIMALS FEELINGS

FEELINGS BIRTHDAY BIRTHDAY FAMILY

COMMUNITY SELF-ESTEEM COMMUNITY

COUNTING ANIMALS BIRTHDAY MANNERS

Chanting, initial /f, t, s, b/d/ words Initial /s/ words Imagining, discussion Noticing the ridiculous, initial /p/ words, absurdities Descriptors

FAMILY

459

460

Appendix F

Book

Language Use

Theme

Jonas, The 13th clue

Descriptors, predicting, visual searching Descriptors, visual searching Accompanies song, rhyming, singing Descriptors, visual searching, initial /g, k/ words Predicting

MANNERS

Jonas, The trek Jonas, This old man Jonas, Where can it be? Joslin & Sendak, What do you say dear Kandoian, Molly’s seasons Keats, Over in the meadow Keats, Peter’s chair

Keats, The snowy day Keller, Geraldine’s blanket Kent, There’s no such thing as a dragon Kennedy & Hague, The teddy bears’ picnic King, Gus is gone King, Lucy is lost Klamath County YMCA Family Preschool, The land of many colors (M) Knowlton, Why do cowboys sleep with their boots on? Krahn, The creepy thing (no words) Krahn, Robot-Bot-Bot (no words) Kraus, Bears Kraus, Leo the late bloomer Kraus, Milton the early riser Kraus, Whose mouse are you? Krauss, A hole is to dig

Plurals, rhyming, descriptors, seasons Singular/plural contrast, present progressive and past tense Present progressive and past tense, possessive -’s, adjectives, discussion Initial /sn/ blends, relating experiences Retelling with present possessive, relating experiences Initial /b/ words, past tense

AUTUMN, WINTER, SPRING COUNTING FEELINGS

WEATHER, WINTER FEELINGS

Initial /s/ words Vocabulary Vocabulary Colors, emotions

Regular and irregular past tense, initial /k/ Following a theme/story line, descriptors Following a theme/story line, descriptors Vocabulary, prepositions, present progressive tense Predicting, emotions, initial /l/ words Chanting, initial /s/ words Possessive -’s, interrogative sentences Expression, make own definitions

COLORS, FEELINGS

CLOTHES

ANIMALS

FAMILY, FEELINGS

Use of Children’s Literature in Preschool Classrooms

Book

Language Use

Theme

Krauss, The carrot seed

Past tense, present progressive tense, sequencing Chanting, predicting

SENSES

Lacome, Walking through the jungle Lear, The owl and the pussycat Lehrman, Loving the earth LeSaux, Daddy shaves Lester, Clive eats alligators Lester, It wasn’t my fault Lewin, Jafta Lewin, Jafta’s mother (M) Lillie, Everything has a place Little, DeVries, & Gilman, Once upon a golden apple Lionni, A color of his own London, Froggy gets dressed London, Let’s go, froggy! Loomis, In the diner Lotz, Snowsong shistling Lukesova, Julian in the Autumn Woods Lyon, Together Macauley, Black and white Maccarone, Itchy, itchy chicken pox Martin, Brown bear, brown bear, what do you see? Martin, The happy hippopotami Martin, Polar bear, polar bear, what do you hear? Martin, When dinosaurs go visiting Martin & Archambault, Here are my hands Marzolla & Pinkney, Pretend you’re a cat

Present progressive and past tense, rhyming Discussion, if . . . then Verbs, third-person -s Verbs, following a theme/story line, third-person -s Chanting, describing Similes Emotions, initial “s” words, nounverb agreement In and on Noticing the ridiculous, responding, chanting Regular plural, /l/ in all positions Regular and irregular past, body parts Prepositions, regular and irregular past Verbs, third-person -s Rhyming, present progressive Regular plurals, emotions Rhyming, chanting, verbs Following a theme/story line Final /tʃ/ words

ANIMALS, COMMUNITY FAMILY SELF-ESTEEM SELF-ESTEEM FEELINGS FAMILY

FEELINGS, COLORS CLOTHING, WINTER

AUTUMN, WINTER AUTUMN, FEELINGS FEELINGS

Sequencing, present progressive, ANIMALS, COLORS, SENSES categorization, rhyming, chanting, adjectives Rhyming Sequencing, present progressive, ANIMALS, COLORS, SENSES categorization, initial /p, b, l/ words, rhyming, chanting Verbs, adjectives Body parts, present progressive Verbs, adjectives, questions

ANIMALS

461

462

Appendix F

Book

Marzollo & Wick, I spy

Language Use

“I spy” game, vocabulary, descriptors Marzolla & Wick, I spy mystery “I spy” game, vocabulary, descriptors Mayer, Ah-choo (No words) Sequencing, descriptors, predicting Mayer, A boy, a dog, a frog and a Sequencing, descriptors friend (No words) Mayer, Frog goes to dinner (No Sequencing, descriptors, words) predicting, following a theme/story line Mayer, Frog on his own (No Sequencing, descriptors, words) predicting, following a theme/story line Mayer, The great cat chase (No Sequencing, descriptors, words) predicting, following a theme/story line Mayer, Hiccup (No words) Sequencing, descriptors Mayer, Just my friend and me Pronouns, verbs, sequencing Mayer, Just me and my little Pronouns, present progressive sister and past tense Mayer, One monster after Initial /g, b/ words another Mayer, There’s an alligator under Sequencing, predicting, present my bed progressive and past tense, prepositions McCarthy, Happy hiding hippos Initial /h, s/ words McCauley, Why the chicken Problem solving, inference, cause crossed the road and effect, idioms and metaphors, temporal markers McCully, Picnic (No words) Descriptors, following a theme/story line McGilvray, Don’t climb out of the Predicting, causal events window tonight McNaughten, Guess who just Predicting, descriptors moved in next door McPhail, Emma’s pet Descriptors Meddaugh, Martha speaks Pragmatics Morninghouse, Nightfeathers Poetry Munsch, The paper bag princess Predictable patterning, inference, logical sequencing, life skills, initial /th/ words, final consonant blends Murphy, What next, baby bear! Predicting, sequencing

Theme

SENSES SENSES

MANNERS FEELINGS FAMILY

FEELINGS

FEELINGS

COMMUNITY

CLOTHES, SELF-ESTEEM

Use of Children’s Literature in Preschool Classrooms

Book

Language Use

Novak, Elmer Blunt’s open house Noll, Jiggle, wiggle, prance

Sequencing descriptors

Numeroff, Dogs don’t wear sneakers Numeroff, If you give a mouse a cookie Numeroff, If you give a moose a muffin Neitzel, The jacket I wear in the snow Offen, The sheep made a leap O’Malley, Bruno, you’re late for school (No words) Oxenbury, The car trip Patron, Dark cloud, strong breeze Peek, Mary wore her red dress

Present progressive tense, vocabulary, prepositions Negatives, verbs, noticing the ridiculous Sequencing, auditory and visual memory, cause and effect, temporal markers, idioms Sequencing, auditory and visual memory, cause and effect, temporal markers, idioms Sequencing, chanting, auditory memory Following directions, verbs Sequencing, descriptors

Initial /k/ words Rhyming, following a theme/story line Predicting, color words, modifiers, initial /r/ words, initial and final /l/ words, chanting, visual detail, sequencing Peppe, Odd one out Visual attending, present progressive and past tense, vocabulary Piper, Little engine that could Predicting Philpot, Amazing Anthony ant Creative rhyming, visual search Polushkin, Mother, mother, I want Noticing the ridiculous, rhyming, another predicting Porter-Gaylord, I love my daddy Causal phrase, discussion because Preston, The temper tantrum Discussion (“I hate it when . . .”) book Raskin, Nothing ever happens on Sequencing, predicting, my block descriptors Raschka, Yo! Yes? Question-answers, chanting, descriptors, inflection Rathman, Good night, gorilla Sequencing, predicting, descriptors Reiss, Colors Vocabulary, adjectives Riddell, The trouble with Noticing the ridiculous, elephants discussion (“if . . . then”)

Theme

ANIMALS

WINTER, CLOTHES

COLORS, CLOTHES

TRANSPORTATION BEDTIME FAMIILY FEELINGS

FEELINGS BEDTIME COLORS

463

464

Appendix F

Book

Language Use

Theme

Rockwell, Big wheels

Vocabulary, adjectives, categories, relating experiences Present progressive tense Initial /st/ blends Vocabulary, categories Vocabulary Vocabulary Present progressive tense, vocabulary, relating experiences Final /g, tʃ/ words

TRANSPORTATION

Descriptors, discussion (All that you are) Pronouns Initial /g, k, f/ blends

SELF-ESTEEM

Rockwell, First comes spring Rockwell, The first snowfall Rockwell, My kitchen Rockwell, Things that go Rockwell, Things to play with Rockwell & Rockwell, At the beach Roddie & Cony, Hatch egg hatch Roe, All I am Roffey, Look, there’s my hat Rosen & Oxenbury, We’re going on a bear hunt Rosen & Robins, Little rabbit foo foo Ross, I’m coming to get you Ruschak, One hot day Russo, The great treasure hunt Ryder, Chipmunk song Ryder, The snail’s spell Schecter, When will the snow trees grow? Scheer, Rain makes applesauce Schories, Mouse around (No words) Scieszka, The true story of the three little pigs Scott & Coalson, Hi Sendak, Alligators all around Sendak, Chicken soup with rice Sendak, Pierre Seuss, Hop on Pop Shaw, It looked like spilt milk

SPRING WINTER TRANSPORTATION SUMMER

CLOTHES

Initial /g, k, f/ words Predicting, discussion about fear and monsters Superlatives, regular and irregular past tense Descriptors, visual searching Imagining Imagining, blends “When . . . and” sentences

FEELINGS SUMMER

ANIMALS AUTUMN

Predicting, noticing the ridiculous, chanting Descriptors, following a theme/story line Predicting, regular and irregular past tense, compare to other versions Initial /m/ words, . . . but MANNERS, COMMUNITY sentences Present progressive tense, nounverb agreement Predicting, months, chanting Chanting, negative, /k/ words MANNERS Rhyming, initial and final /p/ words Predicting, chanting, initial /l/ SENSES words, verbal expression

Use of Children’s Literature in Preschool Classrooms

Book

Language Use

Theme

Shaw, Sheep in a shop

Initial /ʃ/ and final /p/ words, verbs Initial /ʃ/ and final /p/ words, verbs Initial /ʃ/ and final /p/ words, verbs Imagination

COMMUNITY, BIRTHDAY

Shaw, Sheep on a ship Shaw, Sheep out to eat Silverstein, Who wants to buy this cheap rhinoceros? Slepian & Seidler, The hungry thing returns Slobodkina, Caps for sale Small, Imogene’s antlers Smalls-Hector, Jonathan and his mommy (M) Spier, Dreams (No words) Stickland & Stickland, Dinosaur roar! Stinson, Red is best Tafuri, This is the farmer Teague, Pigsty Tojhurst, Somebody and the three Blairs

TRANSPORTATION COMMUNITY MANNERS

Noticing the ridiculous, word and sound play Final /ps/ blends CLOTHES Imagination, discussion (What if . . .) Verbs, following directions FAMILY, COMMUNITY Imagining, descriptors Rhyming, chanting

SUMMER

Initial /r/ words COLORS Third-person -s marker Noticing the ridiculous, initial /p/ ANIMALS words Predicting (twist on The Three Bears), /b/ and b blends, past tense Predicting, sequencing, following a theme/story line Predicting, chanting TRANSPORTATION

Turkle, Deep in the forest (No words) Vagin & Asch, Here comes the cat! Van Laan, Possum come aPresent progressive tense knockin’ Viorst, Alexander and the terrible, Categorization, inference, horrible, no good, very bad day feelings, modifiers, functional vocabulary Viorst, My mama says Adjectives, /k/ words Waddell & Oxenbury, Father Final /k/ words Duck Wells, Noisy Nora Present progressive and past tense, relating experiences Westcott, The lady with the Verbs, prepositions alligator purse Wheeler, Marmalade’s yellow Colors, prepositions leaf Wildsmith, The lazy bear Discussion

FEELINGS

FEELINGS

SENSES, MANNERS

AUTUMN FEELINGS, MANNERS

465

466

Appendix F

Book

Language Use

Wildsmith, What the moon saw Williams, The little old lady who was not afraid of anything

Antonyms Predicting, chanting

Wolf, And then what?

Chanting, “and then . . .” sentences Predicting, /g/ words Present progressive tense, adjectives, synonyms, cause and effect, descriptors, rhyming Initial /l/ words Initial /s/ relative clauses, chanting Posessive -’s marker, categories, vocabulary Verbs Predicting, future tense, discussion Predicting, word associations, categorization Predicting, future tense, initial /s/ words Discussion Discussion Verbal expression, discussion, “because . . .” structures

Wood, King Bidgood’s in the tub Wood, The napping house

Wood, Quick as a cricket Wood, Silly Sally Yabuuchi, Whose footprints? Young, Golden bear (M) Zolotow, Do you know what I’ll do? Zolotow, Some things go together Zolotow, Someday Zolotow, When I have a little boy Zolotow, When I have a little girl Zukman & Edelman, It’s a good thing (M) Denotes multicultural titles that feature minority characters.

Theme

FEELINGS, CLOTHES, AUTUMN

BEDTIME

SELF-ESTEEM

ANIMALS

FEELINGS FAMILY FAMILY

Source: Owens, R. E., & Robinson, L. A. (1997). Once upon a time: Use of children’s literature in the preschool classroom. Topics in Language Disorders, 17(2), 19–48. Reprinted with permission.

Publications to Assist in Classroom Use of Books Charner, K. (1993). The giant encyclopedia of theme activities. Mt. Rainier, MD: Gryphon House. Gebers, J. (1990). Books are for talking, too! A sourcebook for using children’s literature in speech and language remediation. Tucson, AZ: Communication Skill Builders. Jett-Simpson, M. (Ed.). (1989). Adventures with books: A booklist fore pre-K-grade 6. Urbana, IL: National Council of Teachers of English. Lockhart, B. (1992). Read to me, Talk with me (Revised): Language activities based on children’s favorite literature. Tucson, AZ: Communication Skill Builders. Raines, S. C., & Canady, R. J. (1989). Story s-t-r-e-t-c-h-e-r-s: Activities to expand children’s favorite books. Mt. Rainier, MD: Gryphon House. Trelease, J. (1989). The new read-aloud handbook. New York: Penguin.

Glossary ADHD Characterized by overactivity and an inability to attend for more than short periods of time. Although related to LD, the disorder does not manifest itself in severe perceptual and learning difficulties. Anaphoric reference Linguistic device of referring to previously identified information, as in the use of pronouns to refer to previously introduced nouns. Asperger’s syndrome A mild form of pervasive development disorder in which the child exhibits LI and some autistic-like characteristics without the extreme “aloneness” found in many children with ASD. Code switching The shifting from one language to another within and/or across different utterances. Collaborative teaching An educational method that combines consultation, team teaching, direct individual intervention, and side-by-side teaching in which the teacher and speech-language pathologist share the same goals for individual children. Communication event An entire conversation and/or the topic or topics included therein. Conjunction A word that joins together sentences, clauses, phrases, or words. Construct validity Accuracy with which or extent to which a measure describes or measures some trait or construct. Content validity Faithfulness with which a sample or measure represents some attribute or behavior. Contrast training Training method that teaches a child to discriminate between structures and situations that obligate use of the feature being trained and those features that do not. Criterion validity Effectiveness or accuracy with which a measure predicts success. Culture A shared framework of meanings within which a population shapes its way of life. Culture is what one needs to know or believe to function in a manner acceptable to a particular group. It includes, but is not limited to, history and the explanation of natural phenomenon; societal roles; rules for interactions, decorum, and discipline; family structure; education; religious beliefs; standards of health, illness, hygiene, appearance, and dress; diet; perceptions of time and space; definitions of work and play; artistical and musical values; life expectations; and aspirations; and communication and language use. C-unit Nonclausal response to a question in which ellipsis or one main clause plus any attached or embedded subordinate clause or nonclausal structure (T-unit) is evident. Deixis Process of using the speaker’s perspective as a reference. 467

468

Glossary

Dynamic assessment Assessment tasks suggested for children with limited English proficiency (LEP) that emphasize ability to communicate and learn language rather than ability to use grammar. Typical tasks are narration, conversation, or teach-test paradigms. Dysgraphia A writing disorder characterized by letter reversal, misspellings, and word transposition due to no known emotional, environmental, intellectual, perceptual, or obvious neurological problem. Dyslexia A reading disorder, characterized by word recognition and/or reading comprehension abilities two years below the expected level but not due to any known emotional, environmental, intellectual, perceptual, or obvious neurological problem. Echolalia Immediate or delayed whole or partial repetition of previous utterances of others with the same intonational pattern. Ellipsis Omission of known or shared information in subsequent utterances in which it would be redundant. Evidence-based practice (EBP) Clinical practice based on scientific evidence, clinical experience, and client needs. Fetal alcohol spectrum disorder (FASD) A continuum of permanent birth defects caused by materinal consumption of alcohol during pregancy that includes, but is not limited to, fetal alcohol syndrome (FAS). Figure-ground perception Perceptual ability to isolate a stimulus against a background. Functional language intervention A client-based, communication-first assessment and intervention method that employs language as it is actually used as the vehicle for change. Hyperactivity A motor difficulty of overactivity often associated with learning disabilities and accompanied by attention problems. Hyperlexia A variety of Pervasive Developmental Disorder characterized by spontaneous early reading ability and an intense preoccupation with letters and words but little real reading comprehension. Illocutionary function Intention(s) of a speaker. Inclusive schooling An educational philosophy that proposes one integrated educational system— versus the two-tiered system, with regular and special education—based on each classroom becoming a supportive environment for all its members. Interference The influence of one language on the learning and use of another. Interjudge reliability The probability of two judges scoring a child’s performance on a test in the same manner. Interlanguage A combination of the rules of two languages plus ad hoc rules from neither or both languages. Internal consistency Degree of relationship among items and the overall test. Jargon Meaningless combination of words and sounds with the international pattern of speech. Language impairment A heterogeneous group of developmental and/or acquired disorders and/or delays principally characterized by deficits and/or immaturities in the use of spoken or written language for comprehension and/or production purposes that may involve the form, content, and/or function of language in any combination.

Glossary

469

Limited English Proficiency (LEP) Proficiency in another language but not in English. The term is typically used for those who are not truly bilingual because of poor English language skills. Maze Language segments that disrupt, confuse, and slow conversational movements. Mazes may consist of silent pauses, fillers, repetitions, and revisions. Mediational strategies A memory and retrieval strategy in which a word or symbol, such as a category name, is used, as in “types of clothing” or “things that go in the kitchen.” Normed test A standardized test that has been given to a sample of individuals that supposedly represents all individuals for whom the test was designed. Scores are used to determine the typical performance expected for the entire population from whom the sample was drawn. PDD-NOS Pervasive Developmental Disorder–Not Otherwise Specified is mild form of PDD lacking the extreme characteristics of ASD. Perseveration Repetition of the same behavior with a seeming inability to shift to another behavior or to stop. Phonics Sound-letter correspondence used as the basis for most reading instruction. Phonological awareness Literacy knowledge of the sounds and the sound and syllable structure of words. Better phonological awareness is related to better reading and spelling skills are to better phonological production. Presupposition The speaker’s assumption about the knowledge level of the listener, or what the listener knows and needs to know. Print awareness Literacy knowledge that includes knowing the direction in which reading proceeds across a page and through a book, being interested in print, recognizing letters, knowing that words are discrete units, and using literacy terminology, such as letter, work, and sentence. Prognosis Estimate of the rate and extent of recovery from illness or injury. Recast Changed form of a child’s utterance that maintains the same relation and immediately follows the child’s utterance. Referential communication Speaker selects and verbally identifies attributes of an entity, thereby enabling the listener to identify the entity accurately. Reliability Repeatability of a measure, based on the accuracy or precision with which a sample, at one time, represents performance based on either a different but similar sample or the same sample at a different time. Script Basic sequential notion of familiar events. Semantic networking A method of improving reading comprehension, writing cohesion, retention, and recall by teaching organization of information around a central theme or sequence. Sensory integration Interpretation and synthesis of information received from two or more senses, such as hearing and vision. Social disinhibition Inability to inhibit “acting out” behaviors often seen with traumatic brain injury. Standardized test Test in which items are presented, cued, and consequated in a prescribed manner. Story grammar Organizational pattern of narratives. Strategy-based intervention model Training that teaches the child information processing and problem-solving strategies. Systems model Intervention that targets the child’s interactive systems or contexts.

470

Glossary

Topic The subject matter about which the speaker is either providing or requesting information. T-units (minimal terminal units) A main clause plus any attached or embedded subordinate clause or nonclausal structure. Type-token ratio (TTR) Ratio of the number of different words to the total number of words, used as a measure of vocabulary and word retrieval. Validity Effectiveness of a test in representing, describing, or predicting an attribute. A test’s ability to assess what it purports to measure. Working memory Memory in which information is kept active while processed.

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Author Index A Abbeduto, L., 28, 29 Abbott, R., 387, 398, 406 Abkarian, G., 190 Accordo, P., 54 Acevedo, M.A., 111 Acosta, D., 112 Acunzo, M., 172 Adam, G., 44 Adams, C., 43, 44 Adams, M., 323 Adamson, L., 123 Ad-hoc Committee on Service Delivery in Schools, 4 Adler, S., 15, 101, 106, 336 Adlof, S.M., 46, 377, 379 Albert, M.L., 150 Alderete, A., 301 Alibali, M.W., 42 Allen, G.D., 43, 44 Allen, J.B., 383 Allen, R.E., 60 Aloia, M., 37 Alpert, C.L., 53, 246, 255 Alt, M., 44 Alwell, M., 279 The Amazing Writing Machine, 403 American Association on Intellectual and Developmental Disability, 26 American Association on Mental Retardation, 27 American Psychiatric Association, 48, 50, 61

American Speech-LanguageHearing Association, 100, 336, 376 Amerman, J., 91, 184, 287, 318 Anderson, D.R., 219 Anderson, G., 341 Anderson, N.B., 102, 108, 113 Anderson, R., 377 Anderson, R.C., 94, 95, 311 Anderson, R.T., 118, 119 Anderson, T.H., 395 Anderson-Inman, L., 155, 187, 303 Andrews, J., 345 Andrews, M., 345 Andrin-Husemann, D., 372 Anselmi, D., 172 Anthony, J.S., 383 Apel, K., 46, 401, 402 Applebee, A.N., 221 Aram, D.M., 42, 45, 48, 51, 57 Archibald, L.M.D., 42, 46 Arensberg, K., 110 Armbuster, B.B., 395 Arnott, J., 407 Ashton, N., 127 Astington, J., 226 Atchison, B.J., 58, 288 Atkinson, R.H., 302 Audet, L.R., 170, 181, 250, 254 August, D., 379 Aurillo, M.K., 233, 234 B Bacharach, V., 137 Baddeley, A.D., 26, 32, 92 Baghdadli, A., 49

Bahr, R., 341 Bailet, L.L., 94 Bailey, D.B., 262 Bain, B., 71, 124, 242, 255, 273 Baker, J.G., 36 Baker, L., 377 Balason, D.V., 138 Bally, H., 38 Balota, D.A., 191 Banis, C., 207 Baranek, G., 54 Barker, B.A., 62 Barnard, K.E., 60 Barnes, M.A., 56 Barnett, D., 60 Barrow, I.M., 311 Bashir, A.S., 341 Bass, P.M., 37 Bates, E., 25, 85, 105, 191 Battle, D.E., 118, 139, 199 Bauer, N.M., 253 Bauer, S., 48, 49, 50 Bear, D., 401, 402 Beardslee, W., 155 Beasman, J., 341 Beastrom, S., 43 Beatson, J., 54 Beck, A.R., 344, 345 Beck, I.L., 303 Bedore, L.M., 25, 44, 114, 199, 206, 301 Bedrosian, J.L., 125, 126, 156, 158, 162, 164, 291, 292 Beeghly, M., 59, 85 Bell, D., 342 Bell, L., 343 Benasich, A.A., 45

535

536

Author Index

Benson, D.F., 397 Benson, G., 28 Ben-Yishay, Y., 250 Berg, C.A., 233, 248 Bergman, R.L., 62 Berlin, L.J., 301 Berninger, V.W., 387, 397, 398, 400, 403, 406 Bernstein, D.K., 36, 106, 112, 185, 315, 319 Bernstein Ratner, N., 17, 18 Best, S., 65 Biber, D., 114, 146 Biemer, C., 354, 357, 358 Bigler-Burke, L., 6 Billow, J.L., 126, 401 Bilsky, L., 28 Bird, J., 379 Bishop, D.V.M., 23, 42, 43, 44, 46, 61, 178, 214, 315, 379 Bishop, K., 279 Bishop, S.J., 23 Bitner, B., 54 Bjork, E.L., 38, 311 Bjork, R.A., 38, 311 Blachman, B., 383 Black, B., 65 Black-Pond, C., 58 Blalock, J., 398 Bland-Stewart, L., 120 Blank, M., 301, 342 Blashill, M., 288 Bleile, K.M., 120 Bless, D., 28, 29 Bliss, L.S., 208, 209, 290, 326, 327 Bloom, L., 111, 188, 312 Booth, L., 407 Borgh, K., 337 Borkowski, J.G., 393 Borsch, J.C., 372, 373 Bosky, A., 351 Bosman, A., 377 Botting, N., 45 Boudreau, D.M., 28, 42, 296, 380 Bourassa, D.C., 403 Bowers, L., 90 Bowles, R.P., 229, 230 Bowman, S., 148 Boyce, N., 178

Bracken, B., 308 Brackenbury, T., 91, 92, 323 Brackin, S., 171 Bradley, L., 378, 383 Bradshaw, M.L., 274 Brandel, D., 370 Brantley, A.L., 106 Braun, C., 220 Bray, C., 385 Bray, N., 32 Bredart, S., 28, 192 Brekke, C., 45 Bretherton, I., 85, 191 Brice, A., 107 Bricker, D.D., 343 Bridge, C., 32, 300 Brinton, B., 42, 43, 44, 45, 64, 86, 94, 125, 157, 158, 173, 289 Briscoe, J., 45 Bristol, M., 50 Broen, P.A., 64, 244, 255, 256, 257 Brooks, D.W., 404 Brotherson, M.J., 258 Brown, A.L., 377 Brown, B.B., 255, 325 Brown, J., 76, 77, 78 Brown, K.J., 394 Brown, R., 198 Brown, V.L., 89 Browne, K., 60 Bruck, M., 398 Bruning, R., 230, 322 Bruno, R., 100 Bryan, T., 65 Bryant, B.R., 380, 384 Bryant, P., 378, 383 Bryen, D., 250 Buchannan, E., 402 Buckwalter, P.R., 23, 42, 64 Buhr, J.C., 43, 44 Bull, G.L., 337 Bunce, B., 291, 330 Buonaguro, A., 56 Burchinal, M., 27 Burgess, K.B., 45 Burgess, S.R., 383 Burke, A.E., 59 Burns, M.S., 376, 377, 386 Burrows, E., 85

Burton, R., 288 Busch, C., 158 Buschbacher, P.W., 50 Butkowsky, I.S., 377 Butler, D.L., 405 Butler, K., 35, 115, 231, 390 Butler-Hinz, S., 56 Buttrill, J., 354, 357, 358 Buttsworth, D., 56 Buysee, V., 262 Byrne, M.E., 62 C Caccamise, D., 384 Caesar, L.G., 106 Caine, C., 39 Cairns, C., 414 Cairns, H., 414 Cairns, L., 351 Calculator, S.N., 163 Caldwell, J., 382, 383 Cale Kruger, A., 301 Calfee, R., 351, 388, 393 Calvert, M.B., 351 Camarata, M., 6, 271 Camarata, S.M., 6, 45, 197, 271, 325 Campbell, C., 242, 250, 252, 263 Campbell, L.R., 102, 108, 336 Campbell, S.B., 34 Campbell, T.F., 46, 56, 62, 111, 114, 120, 125, 179 Capellini, C., 385 Caplan, D., 56 Cárdenas-Hagan, E., 379 Carlile, R.M., 43, 378 Carlisle, J.F., 95, 115, 392 Carlo, M., 379 Carlson, C.D., 379 Carlson, V., 60 Carmichael Olson, H., 39, 231 Carnine, D.W., 302 Caro, P., 264 Carpenter, A., 183 Carr, A., 394 Carr, S.C., 393 Carrow, E., 88 Carrow-Woolfolk, E., 89, 232 Carson, D.K., 85 Cartwright, A., 403

Author Index

Casby, M., 314 Caswell, S., 255, 343 Catts, H.W., 22, 36, 46, 342, 377, 378, 379, 380, 382 Ceci, S.J., 36, 248 Chafe, W., 189 Chamberlain, P., 103, 107, 108, 111, 113 Champion, T., 102, 108 Champlin, C.A., 47 Chan, H.H., 376 Chaney, C., 383 Channell, R.W., 74, 95, 433 Chapieski, M.L., 246 Chapman, K., 6, 324 Chapman, R.L., 187, 224 Chapman, R.S., 28, 29, 31, 32, 36, 124, 125, 140, 172, 178, 182, 214, 217, 219, 230, 300, 433 Chapman, S.B., 56, 217 Charlop, M., 52 Charney, R., 293 Chatillon, M., 36 Chavez Sanchez, M.L., 334 Chechile, R., 31 Cheng, L.L., 101, 416, 417 Chesnick, M., 64 Chi, M., 248 Chisholm, R., 283 Choudhury, N., 45 Chow, S., 385 Cicchetti, D., 58, 59, 60 Ciccia, A., 289 Cimorell, J., 299 Clahsen, H., 65 Clark, H., 366 Clark, J.O., 321 Clarke, P., 377 Clay, M.M., 383 Cleave, P.L., 44, 255, 258, 270, 301 Clicker 5, 404 Cochran, P.S., 337 Cochrane, R., 122, 244, 262 Coelho, C.A., 56, 167 Coggins, T.E., 39, 58, 87, 122, 123, 124, 128, 129, 231 Cohen, D., 316 Cohen, S., 57 Coirier, P., 397

Cole, K.N., 6, 43, 44, 138, 272, 343 Coleman, M., 49 Coley, J., 137 Coltrane, C., 343 Condouris, K., 122 Condus, M.M., 312 Confal, K.L., 342 Connell, P.J., 42, 44, 48, 115, 251, 252, 253, 271, 272, 305, 322 Connell, R., 105, 115 Connor, C.M., 385 Constable, C.M., 154, 247, 263, 268, 324 Conti-Ramsden, G., 45, 84, 123, 124, 174, 324 Cooper, D.C., 155, 187, 303 Cooper, W., 337 Coplan, R.J., 45 Corriveau, K., 46 Cosaro, J., 354 Coster, W.J., 59, 60 Courchesne, E., 53 Coury, J., 105 Couvillion, L.M., 378 Cowan, N., 24, 47 Cox, M., 126 Crago, M.B., 147 Craig, H.K., 15, 16, 17, 43, 44, 105, 107, 120, 125, 167, 169, 196, 257, 265, 385 Craik, F., 311 Crais, E.R., 91, 92, 137, 138, 217, 219, 244, 258, 301, 303 Cramer, B., 378 Creaghead, N.A., 130, 131, 178 Crede, L.A., 407 Crenshaw, D.A., 59 Creusere, M., 44 Crites, L.S., 41 Crittenden, P.M., 60 Crowe, L.K., 392 Crowe, T.A., 62 Crowhurst, M., 196 Crumrine, L., 351 Crystal, D., 125, 178, 214 Culatta, B., 350, 359, 361 Culp, R.E., 59 Cummins, J., 106, 114 Cunningham, A., 378

537

Cupples, L., 378 Curtis, M.E., 91, 185, 300 Curtiss, S., 65 D Dabasinskas, C., 25 Dahm, P., 255 Dale, P.S., 6, 43, 44, 61, 85, 138, 272, 343 Dallman, W., 433 Damico, J.S., 14, 74, 100, 106, 107, 111, 115, 125, 137, 148, 178, 179, 342, 351 Danserean, D., 369 Dastoli, S.L., 219 Davidson, R., 194 Davies, B., 28, 29, 174, 279 Davis, A., 415 Davis, H., 31 Davison, A., 94 Dawson, G., 53 Day, L., 47 Deacon, J., 32 DeBonis, D., 321, 397, 403, 404, 406, 408 Deevy, P., 47, 325, 326 DeKroon, D.M.A., 124 Demetras, M.J., 52, 53 Denenberg, M.E., 344 Denham, S.A., 288 Denner, P.R., 395, 396 Dennis, M., 55, 56, 75, 219, 315, 344, 345 de Rivera, C., 125 Derr, A., 335 DeSpain, A., 342 DeTemple, J., 383 DeThorne, L.S., 23 deVilliers, J., 91 deVilliers, L., 250 deVilliers, P., 250 Diamond, K.L., 57 Diana v. Board of Education, 100, 106 Dickinson, D.K., 383 Dickson, S.V., 394 Dickson, W.P., 337 Didow, S., 254, 269 Diehl, S.F., 233, 234

538

Author Index

DiScenna, A., 57 Dixon, R.C., 302 Dodd, B., 390, 391 Dodge, E., 396 Dole, J.A., 394 Dollaghan, C.A., 46, 48, 56, 62, 111, 114, 120, 125, 138, 156, 163, 170, 171, 179, 292, 294, 295 Donahue, M., 65, 82, 149, 156 Donaldson, M.L., 301 Donehower, C., 50 Donlan, C., 46 Donnellan, A., 127, 256 Dore, J., 182 Douglas, D., 125 Downey, D.M., 378 Downing, J., 292 Doyle, S., 158 Driver, J., 207, 208 Dromi, E., 44 Duchan, J.F., 8, 19, 73, 75, 86, 122, 136, 153, 154, 177, 178, 188, 209, 217, 226, 242, 246, 247, 248, 253, 254, 297, 340 Duchek, J., 191 Dudley-Marling, C., 9, 342 Duffy, R.J., 56, 167 Dulaney, C., 32 Duncan, B., 79 Dunlap, G., 16 Dunn, D.M., 89 Dunn, L.M., 89 Dunn, M., 192 Duques, S., 94 Dyer, K., 6, 250, 343, 372, 373 E Eccarius, M., 91, 160, 171, 172, 318 Edmaiston, R., 359 Edmondson, R., 262 Edmonston, N.K., 91, 136, 308, 309 Edwards, A., 248 Edwards, J., 45, 46, 384 Ehren, B.J., 342, 344, 345, 358, 393 Ehri, L.C., 377, 402 Eigsti, L., 59 Eisele, J.A., 45 Eisenberg, H.M., 56 Eisenberg, S.L., 129, 194, 331, 333

Ekelman, B.L., 57 Elbert, M., 245 Elizur, A., 62 Ellis, N., 32 Ellis Weismer, S.E., 23, 26, 42, 43, 45, 46, 47, 98, 301, 367, 377 Else-Quest, N.M., 46 Elshout-Mohr, M., 303 Emerick, L., 83 Engel, S., 247, 254 Englert, C.S., 37, 398, 404 English, K., 369 Erickson, L.G., 395 Eriks-Brophy, A., 147 Erskine, B., 37 Ertmer, D.J., 63, 337 Ervin-Tripp, S., 132, 287 Erwin, D.L., 178, 213 Espin, C.A., 337 Evans, A.W., 72 Evans, J.J., 42, 43, 125, 169 Evans, J.L., 23, 46, 47, 98 Evans, L.H., 37 Ewing-Cobbs, L., 55, 56 Ezell, H.K., 29, 383, 386, 388 F Fagundes, D.D., 74 Fairchild, J.L., 289 Fanning, J.L., 400 Farber, J.G., 344, 353 Farrar, M.J., 124, 246 Fasold, R.W., 104, 411, 413 Fazio, B.B., 47, 48, 49 Feagans, L., 29, 149, 173 Fear, K., 398 Feeney, T., 398, 403 Feldman, H.M., 62 Feldman, J.J., 39 Feldman, R.S., 58 Felsenfeld, S., 64 Ferguson, M.L., 370, 373 Ferrell, D., 368 Feuerstein, R., 235 Fewell, R., 27 Fey, M.E., 6, 10, 13, 46, 64, 70, 140, 169, 171, 172, 173, 178, 214, 245, 255, 258, 270, 271, 276, 323, 326, 343, 378, 400, 431, 433

Ficzere, S.A., 405 Fields, H., 398 Fields, T., 404 Fiestas, C.E., 118 Filipek, P., 54 Fillmore, C., 189 Fine, J., 34 Finestack, L.H., 13, 271, 276 Fischel, J.E., 6, 244, 255 Fischer, K.L., 41 Fisher, F.W., 94, 95 Fisher, M., 316 Fitch, J.L., 321 Fitzgerald, M., 128, 192, 194 Fivush, R., 248 Flax, J.F., 45, 192 Fleming, J., 364 Fleming, L.A., 273 Fletcher, J.M., 55 Fletcher, P., 125, 178, 214, 441, 442, 443, 445 Fogel, P., 337 Foley, C., 50 Folger, J., 182 Fontes, L.A., 60 Ford, C., 95 Ford, J.A., 64 Forester, B., 364 Foster, S., 6, 7, 81, 158 Foster, W.A., 379 Fowler, G., 404 Fowler, S., 368 Fox, L., 16, 50, 59 Francik, E., 366 Frazier Norbury, C., 379 Freebairn, L.A., 376 Freed, D., 37 Freeman, N.H., 379 Freeman, S., 406 Freiberg, C., 194, 214 French, L.A., 352 Frey, S., 301 Fried-Oken, M., 92, 93 Friel-Patti, S., 42, 123, 124 Friend, T., 74 Frith, U., 36, 51 Frome Loeb, D., 44, 46, 276, 326 Fuchs, D., 108 Fuchs, L., 108

Author Index

Fujiki, M., 42, 43, 44, 45, 64, 80, 82, 86, 94, 125, 157, 158, 173, 289 Furman, L.N., 29, 247 Fye, E.C., 397, 398 G Galaburda, A.L., 38 Galaburda, A.M., 45 Galda, L., 359 Gallagher, A., 36 Garcia, E.E., 106 Garcia, M., 114 Garcia, S.B., 111 Gardner, D., 18 Gardner, H., 174 Garman, R., 125, 178, 214, 441, 442, 443, 445 Garnett, K., 178, 220 Garrett, Z., 262 Garriss, E., 397, 398 Gast, D., 353 Gathercole, S.E., 42, 45, 46, 92 Gavin, W.J., 85, 186 Gazelle, J., 125 Gee, J.P., 233, 234, 336 Geers, A.E., 63 Gelman, S., 137 Genesee, F., 105, 106 Gentry, B., 37 Gentry, J.R., 402 German, D.J., 35, 36, 38, 92, 186, 191, 301, 311, 315, 316, 317, 353 Gerring, J., 55 Gersten, M.S., 59, 60 Gerstman, L., 28 Ghaziuddin, M., 50 Ghiotto, M., 28, 192 Gibbons, J., 219 Gibbs, R.W., 191 Giles, L., 186 Gill, G., 118 Gillam, R.B., 18, 25, 26, 42, 43, 46, 47, 90, 98, 115, 187, 222, 229, 337, 378, 383, 390, 397 Gillam, S.L., 18 Gillberg, C., 49, 62 Gillespie, L., 57 Gillon, G.T., 390, 406 Gimbert, C., 224

Girolametto, L.E., 6, 15, 125, 255, 256, 263 Glass, A.L., 191 Gleason, J.B., 352 Glenn, C., 221, 224, 225, 296 Godley, D., 191 Goetz, L., 7, 10, 279, 283 Goffman, L., 44 Golder, C., 397 Goldfield, B.A., 283 Goldman, S., 103 Goldstein, B.A., 114, 335 Goldstein, H., 14, 29, 255, 262, 361, 367, 368, 369 Gonzalez, J., 45 Goode, S., 53 Goodluck, H., 327 Goodman, A.M., 39 Gordon, C., 220 Goswami, U., 46 Gottschalk, M.E., 340, 357, 364 Gottsleben, R., 178, 210, 213 Goulandris, N., 378 Graf Estes, K., 46 Graham, A., 312 Graham, S., 397, 398, 403, 404, 406, 407 Graves, A., 398, 404 Graves, M.F., 303 Grawburg, M., 379 Gray, S., 44, 301, 317 Green, J., 59 Green, L.J., 31, 120, 389 Greenberg, D., 377 Greenberg, J., 15, 125, 290 Greenberg, M.T., 60, 288 Greene, J.F., 95 Greenhalgh, K.S., 232 Greenspan, S.I., 53 Grey, S., 91 Griffin, P.S., 62 Griffith, D.R., 41 Griffith, F., 403 Griffith, K.O., 403 Griffith, P.L., 219, 226, 377 Grigorenko, E.L., 38 Gronell, S., 108 Grove, J., 45 Gruenewald, L., 178

539

Guilford, A.M., 315 Gulland, D.M., 321 Gullo, F., 7, 242, 243 Gullo, J., 7, 242, 243 Gummersall, D.M., 217, 296 Gundersen, H., 45 Guralnick, M.J., 64 Gustafson, C., 56 Guthrie, J., 123 Gutierrez-Clellan, V.F., 106, 115, 199, 233, 234, 235, 236 Gutowski, W., 31 H Haaf, R., 79 Haak, N.J., 74 Haas, A., 199, 327, 328 Hadley, P.A., 44, 64, 65, 128, 179, 326, 351 Hale, C., 191 Hale, J.E., 254 Hale-Benson, J.E., 254 Haley, K.L., 6 Hall, N., 48 Hall, R., 302 Halle, J.W., 10, 283 Halliday, M.A., 150 Hamayan, E., 106, 147 Hambly, C., 378, 390, 392 Hamburg, E., 233 Hamman, S., 25 Hammer, C.S., 114, 260, 379, 385 Hammer, M., 58 Hammett, L., 386, 387 Hammill, D.D., 88, 89, 90, 380, 401 Hand, L., 80 Handekman, J., 367 Hanft, B., 50 Hanson, M.J., 109, 113, 260 Haq, F.S., 319 Harbors, H.M., 48 Haring, T., 343 Harris, K.R., 397, 398, 403, 406 Harris, M., 43, 190 Harris, P., 126, 137 Harris, S., 367 Harris Wright, H., 38 Hart, B., 269, 273 Hart, K.I., 45

540

Author Index

Hart, S.A., 23 Hasan, R., 150 Hasenstab, M., 357 Hashimoto, N., 312 Haug, H., 186 Hay, E., 56 Hayes, A., 27 Hayiou-Thomas, M.E., 23 Haynes, J.A., 407 Haynes, W.O., 64, 74, 83, 104 Hayward, D., 222 Hazel, E., 244, 368, 369 Hazen, N.L., 65 Health Resources and Services Administration, 39 Heath, S.B., 234, 298 Heberle, D., 100, 335 Hedberg, N.L., 42, 178, 218, 220, 226 Hedrick, D.L., 41 Heimlich, J., 352, 395 Heinrichs-Ramos, L., 234 Helzer, J.R., 47 Hemphill, L., 23 Henderson, E.H., 402 Henry, F.M., 364 Henry, J., 58 Henry, M., 323 Hepburn, S.L., 27 Herman, J., 312, 313, 314 Herman, P.A., 95, 185, 300 Hermann, D., 36 Hershberger, S., 44 Hesketh, L.J., 26, 43, 44, 46, 47, 301, 318 Hess, C., 128, 186 Hess, L.J., 289 Hester, P.P., 262 Hewitt, L.E., 217, 226, 296, 299 Hiebert, E., 377 Higbee, L.M., 42 Hill, S., 64 Hinds-Howell, D.G., 321 Hinton, L.N., 399 Hirsch, L.S., 45 Hixson, P.K., 178, 214 Hobbs, M., 137 Hodson, B.W., 391 Hoffman, L.M., 26, 46, 61, 98, 192

Hoffman, L.P., 341, 351 Hoffman, P.R., 8, 254, 267, 274, 279 Hogan, T.P., 46, 379 Holbert, D., 311 Holyoak, S., 191 Holzhauser-Peters, L., 372 Hood, L., 188, 312 Hopkins, J., 74 Horn, D., 350, 359, 361 Horn, E., 406 Hoyson, M., 361, 367 Hresko, W.P., 380 Huang, R., 74 Hudson, J., 248 Hugdahl, K., 45 Hughes, C., 197, 407 Hughes, D., 431, 433 Hughes, M., 398 Hughes, S., 155, 168, 174, 181 Huisingh, R., 90 Hummel, L.J., 170, 181, 250, 254 Hunt, P., 7, 10, 279 Hutcheson, G.D., 45 Hutchinson, T.A., 49 Hutson-Nechkash, P., 298 Hwa-Froelich, D.A., 104 Hwang, M., 46 Hyltenstam, K., 106 Hynd, G.W., 45 Hyter, Y.D., 288, 433, 439, 440, 441 I Iacono, T., 378 Iglesias, A., 110, 111, 115, 137, 138, 234, 235, 236 Ingram, D., 65 Invernizzi, M.A., 376, 380, 383, 401, 402 Ionson, M.E., 185 Irwin, J.W., 352 Isaacs, G.J., 105 Isaacson, T., 64 Iseyama, D., 255 J Jackson, S.C., 196 Jackson-Maldonado, D., 112 Jacobson, J., 39 Jacobson, P.F., 110

Jacobson, R., 105 Jacobson, S., 39 James, S., 154 Jamieson, B., 367 Jankovic, J., 23 Jarrold, C., 32 Jenkins, J.R., 95 Jensen, M.R., 235 Jernberg, E., 85 Jerome, A.C., 42, 45 Jimenez, B., 255 Johnson, A., 148, 149, 155, 157, 158, 177 Johnson, B., 258 Johnson, C.J., 124, 161, 185, 294 Johnson, D.L., 233, 398 Johnson, G., 124 Johnson, J., 178, 343 Johnston, E., 148, 149, 155, 157, 158, 177 Johnston, J.R., 13, 22, 26, 42, 45, 136, 178, 192, 221, 224, 230, 251, 260, 261, 264, 296, 383 Johnston, P.H., 377, 380 Jones, A., 190 Jones, C., 123 Jones, M., 45, 47 Jones, S.S., 77 Jones Moyle, M., 23 Jordan, F.M., 56 Joyce, D., 250 Juarez, M., 105 Juel, C., 383 Justice, L.M., 23, 227, 229, 230, 300, 376, 380, 383, 385, 386, 388 K Kaczmarek, L., 368 Kaderavek, J.N., 227, 229, 230, 372, 383, 385 Kail, R., 36, 42, 43, 46, 92, 191, 311, 312, 378 Kaiser, A.P., 6, 64, 107, 242, 246, 253, 254, 255, 262, 273 Kame’enui, E.J., 302, 386, 394 Kamhi, A.G., 13, 36, 37, 42, 46, 65, 73, 74, 75, 77, 80, 126, 178, 192, 206, 283, 331, 342, 378, 399 Kantor, M., 323

Author Index

Kapp, S.A., 57 Kasari, C., 28 Kasher, A., 62 Kashinath, S., 255 Kaston, N., 171, 294, 295 Katz, L.A., 392 Kaufman, R., 258 Kaufman, S.S., 357, 364 Kaye, K., 293 Kay-Raining Bird, E., 28, 29, 31, 233 Kelcher, K., 397 Keller-Cohen, D., 137, 315 Kelly, D.J., 48, 80, 83, 84, 106 Kemp, N., 328 Kemper, S., 148 Kernan, C., 29 Kernan, K., 28 Kiernan, B., 42, 317, 334 Kim, K., 6, 394 Kim, Y., 247, 248 Kinnair, D., 60 Kintsch, W., 392, 397 Kirchner, D.M., 126, 178, 351 Kirk, C., 406 Kjelgaard, M.M., 52 Klecan-Aker, J., 195, 232, 233, 310 Klee, T., 85, 128, 186, 192, 194 Klein, E.R., 353 Kline, A., 289 Klink, M., 28 Klyman, S., 344 Knutson, J.F., 57 Koegel, L., 7 Koegel, R., 343 Kohler, F., 368 Kohler, P.D., 106 Kohnert, K.J., 105, 262, 335 Kopp, S., 62 Koramoa, J., 60 Kouri, T.A., 255, 301, 318, 343, 393 Kovarsky, D., 125, 246 Krantz, L.R., 44 Krashen, S.D., 114 Kriegsmann, E., 286 Kristensen, H., 62 Kristoff, B., 367 Krulik, T.E., 46 Kumpulainen, K., 62

Kunze, L., 254, 269 Kurth, R.J., 337 Kurtz, R., 325 Kusché, C.A., 288 Kushmaul, A.J., 120 Kutz, W., 65 Kwiatkowski, J., 65, 81, 83, 85, 128, 174, 336 Kyratzis, A., 247, 254 Kyte, C.S., 124 L Laakso, M., 37 Labov, W., 411 Lahey, M., 5, 45, 46, 74, 79, 107, 111, 178, 188, 192, 221, 312 Landry, R., 128, 186 Landry, S.H., 155, 168, 174, 181, 246 Lane, S.J., 50, 59 Langdon, H.W., 101, 105 Lange, G., 296 Langenfield, K.K., 343 Langlois, A., 59 La Paro, K.M., 23 Larry P. v. Riles, 100, 106 Larsen, J., 296 Larson, G.W., 73 Larson, S.C., 89, 401 Larson, V.L., 157, 168, 178, 336, 351, 358 Laughton, J., 357 Lau v. Nichols, 100 Law, J., 18, 262 Lawrence, C., 76 Lawrence, F.R., 114, 260 Lawrence, H., 59 Lawrie, B., 390 Layton, T.L., 72 Lazar, R.T., 190, 319, 367 Leavell, A., 398, 404 Lee, L., 178, 214, 312, 420, 427, 430, 432 Lee, R.F., 36 Lehnert, W., 317 Lehr, D., 367 Lehr, E., 55 Lenane, M., 62 Lennon, L., 51

541

Leonard, D., 28 Leonard, J., 44 Leonard, L.B., 32, 36, 38, 41, 42, 43, 44, 46, 47, 48, 65, 70, 92, 169, 171, 191, 206, 283, 301, 311, 312, 314, 325, 326, 378 Lesar, S., 41 Leslie, L., 382, 383 Levin, H.S., 55, 56 Levine, M., 38 Levita, E., 56 Lewis, B.A., 376 Lewis, J., 250, 262 Lewis, L., 297 Lewis, M., 256 Lewnau, L., 411, 414 Lewy, A.L., 53 Liberman, I.Y., 94, 95, 378, 379 Lidz, C.S., 115, 236 Liebergott, J.W., 64, 231 Lieberman, P., 36 Lieberman, R., 74, 75 Lien, P., 222 Lieven, E., 16, 17, 85, 328 Liiva, C.A., 44 Liles, B.Z., 43, 56, 167, 217, 219, 226, 230, 232, 298 Lindamood, C., 351 Lindamood, R., 351 Little, T.D., 379 Lively, M., 431 Lockhart, R., 311 Lockhart, S., 254, 269 Loeb, D., 43 LoGiudice, C., 90 Lohmann, H., 60 Lomax, R.G., 383, 395 Lombardino, L., 247, 248 Lonegan, H., 351 Long, S.H., 13, 27, 59, 140, 178, 214, 215, 255, 258, 270, 271, 276, 431, 433 Longman, D.G., 302 Lonigan, C.J., 6, 244, 255, 383 Looney, S., 255 Lord, C., 52, 53, 288, 289, 291, 293, 316 Lord-Larson, V., 358 Love, R.J., 45

542

Author Index

Loveland, K., 155, 168, 174, 181 Lovett, M., 75, 219 Lovinger, L., 343 Low, W., 433 Lowell, S., 22 Loynachan, C., 406 Lubinski, R., 297 Lucariello, J., 247, 254, 262 Lucas, E., 269 Luce, S., 6, 250, 343, 372, 373 Lund, N.J., 73, 86, 122, 136, 154, 177, 178, 188 Lundgren, C., 194 Lundgren, K., 41 Lutzer, V.D., 36, 319 Lynch, E.W., 109, 113, 260 Lynch, M.A., 58, 60 Lyon, G.R., 36 Lyytinen, P., 37 M MacArthur, C.A., 337, 397, 404, 407 MacDonald, C.C., 39 MacDonald, J., 15, 28, 246, 251 MacLachlan, B.G., 36, 172, 178, 217, 230 Maclean, M., 383 MacWhinney, B., 178, 214 Maddox, M., 207, 208 Madrid, D.L., 106 Maffei, L., 340 Maggart, Z., 178 Magill, J., 288, 289, 293 Maher, S.R., 6 Mahoney, G., 244, 256 Mainela-Arnold, E., 42 Malkin, C., 27 Mallard, A., 396 Malm, K., 101 Manning Kratcoski, A., 399 Mansfield, T.C., 126, 401 Marcano, M., 234, 235 Marcell, M., 32 Markman, E., 294 Marler, J.A., 26, 47, 98 Marlow, N., 45 Marquis, A., 342 Marquis, J., 43

Marsh, H.W., 351 Marshall, C.M., 377 Marshall, K.L., 312 Marshall, R., 45 Martin, G.E., 27 Martin, S.T., 190 Marton, K., 46 Marvin, C.A., 341, 342, 362, 376 Maskowitz, L., 27 Mason, J.M., 383 Mastergeorge, A., 286 Masterson, J.J., 37, 38, 126, 215, 353, 354, 357, 401, 402, 407 Mateer, C.A., 398 Matejka, J., 56 Matsuda, M., 260 Mattes, L.J., 94, 97, 111, 113, 351 Mattson, S.N., 39 Mauer, D., 37, 46 May, S., 194 Mayer, M., 235 McAllister, L.L., 364 McCabe, A., 220, 221, 222, 223, 224 McCaleb, P., 151, 152 McCauley, R.J., 59, 71, 73, 79, 83 McCormick, L., 16, 353 McCracken, J., 62 McCue, M., 64 McDade, H.L., 15, 246, 270 McDaniel, N., 301 McDermott, R., 103 McDonald, T.P., 57 McDuffie, A., 52 McFadden, T.U., 390, 397 McGee, D., 395 McGee, L.M., 383 McGill, K.F., 262, 284 McGonigel, M., 258 McGovern Fersko, T., 194 McGrath, A., 234 McGregor, K.K., 43, 44, 303, 311, 312, 314, 315, 369 McGuinn-Aasby, S., 105 McKee, L., 42 McKeown, M.G., 300, 303 McKinley, N.L., 157, 168, 178, 290, 351, 358 McLean, J.E., 269, 343 McLean, M., 15

McLeod, S., 80 McNaughton, D., 407 McNeish-Stengel, M., 41 McNerney, C., 6 McReynolds, L., 245 McWilliam, R.A., 374 McWilliams, P.J., 258 Medinos-Landurand, P., 103, 107, 108, 111, 113 Medley, L.P., 107 Meier, J.D., 300, 376, 380, 383 Meilijson, S.R., 62 Meline, T., 171 Mental Health Research Association, 62 Mentis, M., 41, 56, 162, 164 Menyuk, P., 64 Merrell, A.W., 80 Merrill, E., 28, 31 Merritt, D., 43, 217, 219, 226, 230 Mersand, J., 403 Mervis, C.B., 28, 29, 246 Mesibov, G., 53 Meskill, R.H., 36 Messick, C., 126, 158, 329 Meyer, A., 337 Meyer, E., 122 Meyers, L.F., 337 Miall, D., 317 Miccio, A.W., 114, 379, 385 Michael, A., 74, 75 Michaels, S., 234 Middleton, J., 55 Miguel, S.A., 73 Milan, S.E., 107 Miles, S., 124, 219 Miller, B.L., 370, 371, 372, 373 Miller, C.A., 42, 46, 326, 378 Miller, J.F., 140, 156, 178, 186, 194, 197, 198, 214, 292, 420, 421, 433 Miller, L., 74, 75, 76, 115, 231, 235, 340, 342, 343, 370 Miller, L.F., 315, 319, 342, 358 Miller, L.J., 50 Miller, M., 379 Miller, S.R., 312 Mills, R., 138 Milosky, I., 283, 366 Milosky, L.M., 64, 317

Author Index

Minami, M., 224 Miniutti, A., 34 Minor, J., 46 Miolo, G., 32 Mire, S., 283 Mirenda, P., 51, 127, 256 Mirrett, P.L., 27, 33 Mistry, J., 296 Moats, L.C., 95, 323, 324, 399, 402, 403 Moe, A., 352 Moeller, M., 91, 160, 171, 172, 318 Money, S., 28 Montague, M., 398, 404 Montgomery, A., 75, 77, 79, 80, 433 Montgomery, J.W., 42, 43, 46, 47, 48, 49, 98, 107, 318, 342, 362, 370, 371, 396, 397 Moore-Brown, B., 370, 372, 373 Moran, C., 56, 319 Moran, M., 28, 104 Mordecai, D.R., 178, 214 Morgan, M., 64 Morohov, J.E., 44 Morris, J., 126, 137 Morris, R., 38, 48 Morrisete, M.L., 301 Morsink, C., 404 Moses, N., 340 Mosisset, C.E., 60 Mosley, J., 31 Mountain-Kimchi, K., 50 Mullin, K., 65 Mullins, B., 358 Muma, J., 80, 82 Mundy, P., 28 Muñoz, M.L., 187, 229 Murdoch, B.E., 56 Murdock, B., 56 Murray, S.L., 351 Murray-Branch, J., 270 Musselwhite, C., 110 N Nagel, K., 123 Nagy, W.E., 94, 95, 185, 300, 311 Nakamura, M., 341 Nakayama, M., 251 Nali-Chiwetula, B.J., 18

Nancollis, A., 390 Naremore, R.C., 48, 218, 297, 298 Nash, M., 301 Nathan, D., 124 Nathan, L., 378 Nation, K., 377, 379 National Council of Teachers of English, 354 National Joint Committee on Learning Disabilities, 34 National Reading Panel, 390 Nawojczyk, D.C., 315 Needleman, H., 111, 114 Neeley, P.M., 248 Neeley, R.A., 248 Neetz, J., 343 Nelson, C.D., 303 Nelson, K.E., 6, 15, 45, 105, 247, 248, 271, 352 Nelson, L., 46, 331 Nelson, N.W., 14, 42, 55, 98, 178, 296, 299, 300, 302, 340, 341, 342, 343, 346, 348, 351, 352, 358, 365, 382, 383, 384, 399, 400, 433, 439, 440, 441 Nemeth, M., 44 Nett, K., 262 Newell, A.F., 407 Newhoff, M., 38, 158 Newman, J., 75, 219 Newman, R.M., 43, 303 Newman, R.S., 191, 301 Newman, S., 398 Nicholas, J.G., 63 Nicholas, M., 150 Nicholson, C.B., 190, 319, 367 Nicolson, R., 62 Niizawa, J., 354, 357, 358 Nippold, M.A., 37, 65, 74, 91, 94, 126, 153, 185, 187, 190, 191, 195, 196, 206, 289, 300, 314, 315, 319, 321, 322, 330, 331, 352, 401 Niquette, G., 377 Norman, K., 351 Norris, J.A., 8, 91, 94, 185, 195, 196, 230, 254, 267, 274, 279, 322, 340, 342, 344, 354, 357, 358 Norris, M., 105 North, K.H., 298

543

North, T., 46 Nugent, P., 31 Nye, C., 6, 7, 81, 262 O Oaks, R., 372, 373 Obler, L.K., 150 O’Brien, M., 123 O’Connor, E., 25 O’Connor, L., 336, 357 Odom, S., 367 O’Donnell, B., 376 Oetting, J.B., 43, 44, 301 Ofiesh, N., 407 Ohberg, A., 379 Ohletz, A., 18 Okamoto, C., 34 Oller, J.W., 14, 351 Olswang, L.B., 6, 15, 39, 58, 71, 87, 122, 123, 124, 242, 255, 273, 286, 290 O’Malley, K.D., 39 Omanson, R.C., 303 Omark, D.R., 108, 111, 113 O’Neil-Pizozzi, T.M., 61 Oram, J., 34 Ortiz, A.A., 111 Orum, L., 233 Osberger, M., 91, 160, 171, 172, 318 Ostertag, J., 395 Owens, R., 6, 15, 16, 26, 28, 30, 33, 182, 183, 199, 327, 328, 362, 394, 466 Ozanne, A.O., 56 P Páez, M.M., 229 Palin, M.W., 178, 214 Palincsar, A.S., 377 Palmer, C.B., 178, 214 Pan, B.A., 352 Panagos, J., 226 Papanicolaon, A.C., 57 Paradis, J., 110 Paratore, J.R., 399 Parente, R., 312, 313, 314 Parnell, M., 91, 184, 287, 318 Parsons, D., 386 Patrick, C., 388, 393

544

Author Index

Patterson, J.L., 112 Patterson, P.A., 323 Paul, R., 42, 255, 315, 316, 317, 318 Pawlowska, M., 325 Payne, K., 102 Pearson, N.A., 90 Pease, D.M., 352 Pecyna-Rhymer, P., 367 Pehrsson, R.S., 395, 396 Pellegrini, A.D., 359 Pemberton, E.F., 271 Peña, E.D., 114, 115, 118, 187, 229, 235, 236 Perera, K., 206, 213 Perez, C., 224 Perez, D., 105 Perin, D., 377 Perkins, M., 105 Perlman, R., 124 Perlmutter, J., 359 Perozzi, J.A., 334 Perrey, C.D., 353, 354, 357 Perry, B.D., 59 Perzsolt, F., 18 Petersen, A., 49 Peterson, C., 222 Peterson, P., 367 Petrill, S.A., 23 Phillips, C.E., 32 Philofsky, A., 27 Piacentini, J., 62 Piche, G.L., 196 Pickles, A., 84 Pittelman, S., 352, 395 Plante, A.S., 378 Plante, E., 22, 44, 45, 47, 79, 80, 91, 323 Platt, J., 124 Pohlman, J., 125, 126 Poikkeus, A., 37 Pollack, S., 178 Pollard-Durodola, S.D., 379 Polmanteer, K., 259 Pond, R.E., 107 Posquine, E., 46 Powell, A., 256 Powell, T., 245

Power, M.A., 95 Preece, A., 220 Prelock, P.A., 54, 158, 340, 343, 357, 364, 370, 371, 372, 373 Prendeville, J., 353 Pressley, M., 393 Price, J., 33 Price, T.S., 61 Prinz, P., 217 Prizant, B.M., 6, 49, 52, 54, 107, 151, 152, 289, 374 Proctor-Williams, K., 276 Pruess, J., 27 Prutting, C.A., 14, 56, 126, 154, 157, 162, 164, 166, 178, 351, 420 Pry, R., 49 Pudlas, K., 367 Purcell, S., 230 Pye, C., 91, 92, 178, 214 Q Qi, C.H., 64, 107 Quinn, R., 233, 235, 236 R Raaska, H., 62 Rand, Y., 235 Randall, David, E., 108, 109 Raphael, L., 28 Raphael, T.S., 37, 398 Rapoport, J.L., 62 Rapoport, M.D., 53, 292 Rasanen, E., 62 Rashotte, C., 384 Rastatter, M.P., 311 Ratner, N.B., 43 Ray, S., 73, 74 Realpe-Bonilla, T., 45 Records, N.L., 42, 79 Redmond, S.M., 44, 64 Redmont, S.M., 192 Reed, N.L., 370, 371, 372 Reed, V.A., 35, 38, 363, 364 Rees, N., 152, 167 Reich, P., 210 Reichle, J., 158 Reid, D.K., 380 Reilly, R.M., 303

Rein, R., 29 Relich, J., 351 Rescorla, L., 18, 42, 43, 61, 378 Restrepo, M.A., 112, 197, 199, 323 Reutzel, D.R., 395 Reznick, J.S., 85 Rhodes, L., 9 Rhyner, P.M., 106 Rice, M.L., 42, 43, 44, 48, 61, 64, 65, 80, 83, 84, 192, 242, 247, 301, 327, 351 Richardson, J., 126 Riches, N.G., 324 Richgels, D., 395 Riddle, L.S., 47, 378, 390, 392 Rieke, J., 250, 262 Riley, S.A., 393 Rinehart, S.D., 395 Ripich, D.N., 6, 219, 226, 340 Rispoli, M., 179 Rivers, K.O., 41 Roberts, J.E., 27, 33, 61, 107, 137, 138, 196, 374 Robertson, C., 384 Robertson, S.B., 367 Robinson, H.A., 395 Robinson, L.A., 289, 362, 466 Rodgers-Rhyme, A., 372 Rodino, A.M., 224 Rodriguez, B.L., 15, 260 Rodriguez, T., 341, 342 Roeper, T.W., 91 Rogan, L., 407 Rogers-Warren, A., 6, 16, 53, 246, 255, 273 Rolland, M., 194, 214 Roller, E., 341, 342 Rollins, P.R., 220, 221, 222, 223 Rom, A., 65 Roman, R., 233 Romski, M.A., 367, 368 Rondal, J., 28, 192 Rosa, M., 110 Rose, D., 337 Rose, S.A., 301 Roseberry, C., 105, 115 Roseberry-McKibbin, C.A., 112, 139, 154

Author Index

Rosegrant, T.J., 337 Rosen, C., 55 Rosenkoetter, S.E., 353 Rosenthal, J.B., 80 Rosin, M., 28, 29 Rosin, P., 118 Rosinski-McClendon, M., 158 Ross, B.L., 233, 248 Ross-Allen, J., 353 Roth, F.P., 82, 128, 129, 130, 134, 135, 136, 139, 148, 149, 150, 154, 155, 156, 157, 158, 167, 170, 178, 184, 217, 220, 224, 226, 316, 397, 398, 405 Routman, R., 402 Rubin, E., 51 Rubin, H., 94, 323 Rubin K.H., 45 Ruder, C., 291, 330 Ruder, K., 291, 330 Rudzinski, M., 190, 321 Ruhl, K., 197 Rumsey, J.M., 53, 292 Rush, D., 153 Russell, A.F., 124 Russell, N., 55, 56, 97, 242, 250, 264 Russell, S.C., 372 Rutter, M.L., 53, 293 Rvachew, S., 379 S Sabbadini, L., 65 Sadagopan, N., 63 Sagi, S., 60 Sailor, W., 283 Salter, W., 384 Salzinger, S., 58 Samuel, A., 25 Sandall, S.R., 15 Sanders, J., 321 Santarcangelo, S., 250 Sapona, R.H., 253 Sarno, M.T., 56 Sattler, J.M., 34 Savage, R., 55, 56 Saville-Troike, M., 104, 254 Sawyer, D.J., 36, 37, 351 Sawyer, J., 414

Scarborough, H.S., 178, 194, 376, 377, 386 Sceery, W.R., 53, 292 Schaffer, M., 194 Scheffner Hammer, C., 259 Scherer, N., 6 Schery, T.K., 336, 357 Schetz, K., 358 Schiff-Myers, N., 105, 106, 113 Schmidt, H.D., 372 Schneider, P., 124, 219 Schneider, W., 393 Schneider-Rosen, K., 60 Schober-Peterson, D., 161, 294 Schommer, M., 94, 311 Schommer-Aikins, M., 391 Schopler, E., 53 Schore, A.N., 60 Schreibman, L., 49, 52, 53 Schuler, A.L., 52, 54 Schultz, L.H., 155 Schultz, M.M., 395 Schwartz, L., 290 Schwartz, R.G., 6, 46, 110, 158 Schwartz, S.E., 28, 29 Schwartz, S.S., 404 Schwarz, I.E., 153, 319 Schwentor, B.A., 55 Scott, C.M., 35, 91, 94, 146, 153, 178, 185, 192, 195, 196, 199, 206, 213, 217, 219, 343, 364, 397, 406, 407 Scott, J.A., 377 Scott, P., 153 Seaman, D., 6, 7, 81 Searle, D., 398 Seaton, C., 289 Secord, W.A., 125 Sefton, K., 128, 186 Segal, E., 153 Segebart DeThorne, L., 23, 42, 377 Segers, E., 391 Seidenberg, P.L., 36, 37, 185, 319, 363 Selber Beilinson, J., 290 Selinker, L., 125 Selle, C.A., 393 Selman, R.L., 155

545

Semel, E.M., 65, 308, 312, 348, 358 Sena, R., 137 Seung, H., 32 Sewell, T.E., 236 Seymour, H.N., 91, 107, 110, 120, 127 Shadden, B.B., 167 Shafer, K., 369 Shankweiler, D., 94, 95, 378 Shaywitz, B.A., 36, 38 Shaywitz, S.E., 36, 38 Shearer, W., 345 Shelton, B., 353 Shewan, C., 101 Shin, H.B., 100 Shipley, K., 207, 208 Short, E., 149, 173 Short, H., 44 Short-Meyerson, K., 28 Shriberg, L.D., 28, 65, 81, 83, 85, 128, 174, 336 Shumway, S., 52 Siegel, L.S., 255 Sigman, M., 28 Silliman, E.R., 221, 233, 234, 341, 348, 351 Silovsky, J., 58 Simkin, Z., 84 Simmons, D.C., 386, 394 Simon, C.S., 178, 342, 351 Simon, E., 36 Simon-Cereijido, G., 106 Sindberg, H.A., 32, 124, 300 Sindelar, P.T., 337 Singarcharlu, S., 62 Skarakis-Doyle, E., 65, 79 Skibbe, L.E., 23 Slackman, E., 248 Sleight, C., 217 Sliwinski, M., 192 Sloane, M., 58 Slobin, D., 325 Smith, B., 15 Smith, C., 95, 323, 324 Smith, L., 137 Smith, R., 219 Smith, V., 51 Smitherman, G., 336

546

Author Index

Snell, M.A., 65, 264 Snell, M.H., 351 Snow, C.E., 94, 124, 283, 376, 377, 379, 386 Snow, D., 42, 47 Snowling, M.J., 36, 42, 51 Snyder, L., 85, 191, 395 Snyder, L.E., 25, 384 Snyder, L.S., 191, 378 Snyder, T., 336 Snyder-McLean, L.K., 269, 343 Sohlberg, M.M., 398 Solesby, S., 28, 29 Sonnenberg, E., 173 Sonnenmeier, R.M., 359, 361 Southwood, F., 124 Spackman, M.P., 44 Sparks, S.N., 58, 59 Spector, C., 65 Spekman, N., 128, 129, 130, 134, 135, 136, 139, 148, 149, 150, 154, 155, 156, 157, 158, 167, 170, 184, 217, 220, 226, 316, 397, 398 Spencer, L.J., 62 Spicer, L., 363 Spinelli, F., 6, 12, 86, 254, 265, 340 Sprott, R.A., 148 Spruytenburg, H., 248 Squire, L., 25 Staab, C., 16, 269, 366 Stackhouse, J., 378 Stahl, S.A., 395 Stainback, S., 341 Stainback, W., 341 Stanovich, K.E., 378, 379 Stark, J., 152 Steffani, S.A., 210, 212 Stein, N., 221, 224, 225, 296 Steiner, S., 336 Steiner, V.G., 107 Stephens, I., 433 Stephens, M., 75, 77, 79, 80 Sternberg, R.J., 300 Stickler, K.R., 178 Stockman, I.J., 118, 125, 139, 188 Stoel-Gammon, C., 178, 218, 220, 226 Stokes, S.L., 192

Stone, C., 42, 322 Stone, W., 52 Storkel, H.L., 301 Stothard, S.E., 42 Stowe, L., 191 Strain, P.S., 367, 368, 369 Street, C.K., 35 Streissguth, A.P., 39 Stremel-Campbell, K., 242, 250, 252, 263 Strong, C.J., 217, 232, 296, 298 Strong, J., 183 Strong, L.M., 63 Stroud, A., 31 Sturm, J.M., 365 Sturner, R.A., 72 Stuss, D.T., 397, 398 Sullivan, P.M., 57 Sulzby, E., 383 Summers, J.A., 258 Summers, P.A., 73 Sussman, J., 47 Svenson, L., 87 Swank, L.K., 379 Swank, P.R., 233 Swanson, T.J., 391 Swartzfager, J.L., 107 Swift, E., 28, 29 Swing, S., 367 Swisher, L., 22, 42, 47, 52, 53, 59, 73, 79, 83, 323, 334 Szekeres, S., 57, 403 T Tager-Flusberg, H., 52, 122, 315, 316 Tallal, P., 65 Tannock, R., 31, 255 Tarone, E., 148 Tattershall, S., 358 Taylor, O.L., 101, 102, 104, 336, 415 Templeton, S., 401, 402 Terrell, B.Y., 6, 12, 86, 254, 265, 324 Terrell, S.L., 110 Terwogt, M., 126, 137 Tesner, H., 298 Thal, D., 42, 112 Thane, N.L., 91, 136, 308, 309

Theadore, G., 6, 350, 359, 361 Theimann, K.S., 14, 262 Thomas, C., 404 Thomas, J., 128 Thomas-Tate, S., 107, 384 Thompson, B., 394 Thompson, Z., 50 Thompson-Porter, C., 196 Thorne, J.C., 231 Thorum, A.R., 88 Thousand, J., 118 Timler, G.R., 58, 122, 262, 284 Tipton, C., 248 Todd, C.M., 44 Tomasello, M., 60, 124, 172, 246, 301, 324, 327, 328 Tomblin, J.B., 23, 42, 43, 46, 48, 61, 62, 64, 79, 378 Tomlin, R., 125 Tönsing, K.M., 298 Torgesen, J.K., 377, 378, 379, 384 Torreiter, S.M., 185 Towey, M., 385 Trabasso, T., 317 Trathen, W., 394 Treiman, R., 377, 378, 399, 403 Troia, G.A., 397, 403 Trubiville, V., 259 Tsatsanis, K.D., 50 Tucker, J., 348 Turkstra, L.S., 56, 289 Turnbull, A.P., 258 Turner, L., 32 Tyack, D., 178, 210, 213 Tyler, A., 95 U Uccelli, P., 23, 229 Udvari, A., 118 Ukrainetz, T.A., 227, 229 Undlin, R.A., 153 U.S. Bureau of the Census, 233 U.S. Department of Health and Human Services, 57, 58 V Vace, N.N., 404 Vadasy, P., 27

Author Index

Vallecorsa, A.L., 397, 398 Vance, R., 79, 91 van Daalen-Kapteijns, M.M., 303 Van Den Broek, P., 317 van der Lely, H.K., 43, 190 Vander Woude, J., 386, 387 Van Dongen, R., 178 van Kleeck, A., 231, 260, 319, 386, 387, 389, 390 Van Meter, A.M., 287, 382, 383, 384, 399, 400 van Orden, G., 377 Varnedoe, D., 15, 246, 270 Vaughan, K., 398, 406 Vaughn-Cooke, F., 188 Venn, M.L., 273 Verhoeven, L., 391 Vermeulen, K., 387 Vetter, D.K., 233 Vine, E., 317 Violette, J., 52 Vis Dubé, R., 124 Vogler-Elias, D., 262, 284 Volkmar, F.R., 289 Volterra, V., 65 Von Berger, E., 25 Vygotsky, L., 115

W Wagner, J.R., 327 Wagner, R.E., 378, 384 Wagstaff, D.A., 385 Walden, T.A., 247 Wales, R., 137 Walker, D.R., 50 Wallace, G., 88 Wallach, G.P., 35, 64, 231, 290, 315, 319, 342, 358, 390 Wallach, H., 120 Walpole, S., 300 Waltzman, M.M., 153 Ward-Lonergan, J.M., 400 Warner, J., 341, 342 Warren, S.F., 6, 10, 16, 242, 246, 248, 253, 254, 255, 273 Warr-Leeper, G.A., 172, 173, 190, 319, 367

Washington, J.A., 43, 105, 107, 120, 167, 196, 384, 385 Wasserman, G.A., 60 Waters, G., 56, 398 Watkins, R.V., 42, 43, 48, 56, 59, 271, 327, 377 Watson, D., 108 Watt, N., 52 Way, I., 287 Wayman, K.I., 113, 260 Webb, W.G., 45 Webber, S., 172, 173 Weber, S.E., 386 Webster, P.E., 378 Weeks, S., 32 Wehmeyer, P., 397 Weiler, E.M., 340, 357, 364 Weiner, F., 178, 214, 411, 414 Weinrich, B., 148, 149, 155, 157, 158, 177 Weismer, S.E., 44, 270, 318 Weiss, A., 341 Weistuch, L., 255, 256 Weitzman, E., 15, 256, 263, 290 Weitzner-Lin, B., 19 Weller, E., 244 Wellman, H., 352 Wells, G., 194, 213 Welsh, J., 45, 271 Wentzel, M., 53 West, G., 190 Westby, C.E., 60, 102, 104, 178, 220, 233, 340, 350, 352, 354, 359 Westman, M.J., 244, 255, 256, 257 Weston, D.R., 41 Wetherby, A.K., 52, 107 Wetherby, A.M., 49, 52, 54, 289 Wexler, K., 43, 44, 48 Wheeler, L., 127 Whitaker, H.A., 57 Whitcomb, J., 385 White, S., 95 White, T.G., 95 Whitehurst, G.L., 6, 244, 255 Wickstrom, S., 361, 368 Widder, C., 28 Wieder, S., 53 Wiederholt, J.L., 380

547

Wiedl, K.H., 115 Wiegel-Crump, C.A., 315 Wiig, E.D., 77 Wiig, E.H., 36, 38, 65, 77, 125, 308, 312, 348, 358, 364, 376 Wiigs, M., 263 Wilce, L., 377 Wilcox, K., 105 Wilcox, M.J., 255, 343 Wilkinson, G.S., 401 Wilkinson, I., 283, 366 Wilkinson, K.M., 367, 368 Wilkinson, L.C., 351 Willbrand, M., 80, 82 Williams, F., 414 Williams, J.P., 395 Williams, K., 107 Williams, L., 6, 343, 372, 373 Williams, R., 411, 413 Williams, T., 293 Willis, D., 58 Willis, T., 125, 291, 292 Willows, D.M., 377 Wilson, B.A., 391 Wilson, C.C., 36 Wilson, K., 351 Windsor, J., 35, 46, 315 Wing, C., 311, 314 Winkler, E., 43, 173 Winner, E., 190 Winner, K., 23 Winograd, P.N., 377, 380 Winton, P., 258 Wise, B., 384 Wixson, K., 351, 380 Wolcott, G., 55, 56 Wolery, M., 273, 353 Wolf, M., 38 Wolfram, W., 106, 411, 413 Wollner, S., 152, 167 Wong, B.Y., 397, 404, 405 Wong, M.Y.A., 260, 261 Woodcock, R.W., 380 Woodley-Zanthos, P., 32 Woods, J.J., 54, 255 Wooldridge, P., 32 Wren, C., 81, 82, 83, 120 Wright, D., 362, 376

548

Author Index

Wright, S., 398 Wulfeck, B., 25 Wyckoff, J., 194 Wysocki, K., 95 Y Yates, C., 403 Yelsma, P., 287

Yim, D., 262 Ylvisaker, M., 55, 56, 57, 321, 397, 398, 403, 404, 406, 408 Yochum, M., 351 Yoder, P.J., 6, 29, 52, 174, 246, 248, 255, 279 Yopp, H.K., 378 Yoshinaga-Itano, C., 395

Z Zaidman-Zait, A., 51 Zhang, X., 43, 46, 64 Zhang, Y., 404 Zimmerman, I.L., 107 Zitnay, G.A., 55 Zureich, P.Z., 376 Zwaigenbaum, L., 50

Subject Index A Abbreviated episodes, 226 Abstraction, levels of, 389 Abuse emotional, 58 language impairment and, 57–61 physical, 58 sexual, 58 Acculturation, language and, 259 Acronyms, 404 Action requests for, 285 sequences, 225 ADHD. See Attention deficit hyperactivity disorder (ADHD) Adjectivals, 204 Adjectives, 331 Adolescents at-risk, identifying, 348–53 conversational ability and, 289 lexical items for, 185 linguistic awareness intervention for, 362–64 T-units and C-units for, 196 Adults directive style of, 256 perseveration in, 181 speech contingencies in, 262 Adverbial conjuncts and disjuncts, 152–53 African American English (AAE), 100, 104, 110, 120, 196, 199, 233, 336, 410–17 Standard English versus, 410–13 African Americans bias in assessment and, 107–8 early literacy and, 385 learning styles of, 254 narratives and, 224, 234 Alcohol-related neurodevelopmental disorder (ARND), 40

Alexithymia, 60 Alternate form reliability, 72 Alternative assessment, 110–11 American Association on Intellectual and Developmental Disabilities (AAIDD), 26 American English, 100 American Speech-Language-Hearing Association (ASHA), 17 web site for, 19 Analogical reasoning skills, training, 355–57 Analogies, 354 Analysis cohesion, 221 computer-assisted language, 214–15 disruption categories, 180–81 ethnographic, 155 high-point, 222–24 language sample methods, 178 molar level, 154 molecular level, 154 morphological, 197, 199–201 narrative, 217–37 pronoun, 200 spelling, 402 story grammar, 228 syntactic, 201, 204, 206–11, 213 beyond utterance, 146 at utterance level, 177 Analysis across utterances and partners, 147–53 cohesive devices, 151–53 referential communication, 148–51 stylistic variations, 147–48 Anaphoric reference, 152 Appendages, 229 Appropriateness, of intentions, 183–84 Appropriateness-before-action pattern, 287 Articles, 328–29 Asian English, 416–17

549

550

Subject Index

Asperger’s syndrome (AS), 50, 51 conversational ability and, 289 Assessment alternative, 110–11 aspects of language, 90–95 authentic, 118 bias, overcoming, 107–11 cultural variants influencing, 103 curriculum-based, 348 descriptive approach, 80–83 dynamic, 113 of information-processing deficits, 98 integrated functional strategy, 83–98 integrated model for, 111–20 interpreters, use of, 108–10 lack of tools, 106–7 of phonological awareness, 384 of preschool-age children, 70–98 psychometric protocols, 73–80 psychometric versus descriptive procedures, 71–73 reading, 380–85 of reading comprehension, 384–85 reliability, 72 sampling, 97–98 of school-age children, 70–98 spelling, 401–3 test modification, 95–97 tools, 351 validity, 72, 73 writing, 95, 399–403 Assigning Structural Stage, 420–21 Associate cueing, 316 At-risk children, identifying, 346–53 preschool-age, 350 school-age and adolescent, 351–53 Attention, 24, 31, 33 calling for, 284–85 Attention deficit hyperactivity disorder (ADHD), 34 fetal alcohol syndrome and, 40 pervasive developmental disorder and, 48 writing and, 398 Attribute cueing, 316 Audio recording, 139 Augmentative and alternative communication (AAC), 52 Authentic assessment, 118 Autism Society of America, 48 Autism spectrum disorder (ASD), 15, 27, 48–54 biological factors, 52–53

causal factors of, 52–54 conversation initiation in, 155–56 language characteristics, 51–52 processing factors, 54 social-environmental factors, 53 Auxiliary verbs, 325, 326 specific language impairment and, 44 B Barrier tasks, 135 Bell-shaped curve, 75 Bias African Americans and, 107–8 overcoming, in assessment, 107–11 Bilingual learners, 105 Black English, 410–17 Bootstrapping, 23 Brain, central executive function, 26 Brain injury cerebrovascular accident (CVA), 57 prognosis, 55 traumatic, 55–57 Breakdowns, 275 Buildups, 275 C Caregivers abuse by, 60 conversational style of, 255–58 functional assessment and, 84–85 observation of, 85, 87 requests for objects and, 286 Carrow Elicited Language Inventory, 88 Causal chains, 222 Causal factors of autism spectrum disorder, 52–54 of language learning disability, 37–38 of maltreatment, 59–60 of mental retardation, 29–32 of pervasive developmental disorder, 52–54 of specific language impairment, 45–47 of traumatic brain injury, 56–57 Centering, 221 Central executive function (CEF), of brain, 26 Central nervous system dysfunction, 34 Cerebrovascular accident (CVA), 57 language characteristics, 57 Chaining, 221 Channel availability, 148

Subject Index

Childhood schizophrenia, 61–62 Children at-risk, identifying, 346–53 bilingual, 105 with CLD backgrounds, 199, 201, 259–62, 333–36, 379–80, 410–17 conversational partners, 126–27 conversational repair by, 171 descriptive approach of assessment, 80–83 with different dialects, 118–20 directive verbal feedback to, 257 illocutionary functions in, 182–83 integrated functional assessment strategy, 83–98 language characteristics of, 28 language intervention for, 246–47 with minority dialects, 336 perseveration in, 181 psychometric assessment protocols for, 73–80 psychometric versus descriptive procedures, 71–73 reading problems in, 377–79 talking with, 367–70 Children’s literature, 362 in preschool classrooms, 454–66 Children’s Test of Nonword Repetition, 92 Child variables, 128 Classroom activities, structuring, 363 Classroom model elements of, 346–70 instituting, 370–74 Classroom participation, 365 Classroom teachers, speech-language pathologists and, 344–45 Clauses, 210 relative, 211 Clinical question, 18 Cloze tests, 95, 321 Code switching, 148, 413 Cognitive/academic language proficiency (CALP), 334 Cognitive deficits, 55 Cognitive process-based interventions, 8 Cohesion analysis, 221 in narration, 298–99 referential, 299 Cohesive devices, 150, 151–53 adverbial conjuncts and disjuncts, 152–53 conjunctions, 152–53, 232 contrastive stress, 153

551

ellipsis, 152 lexical items, 232 of narrative analysis, 230–32 reference, 151–52, 231 substitution and ellipsis, 231 types of, 236 Collaborative teaching, 342–43 Comment, 167 Communication, referential, 148–51 Communication and Symbolic Behavior Scales, 107 Communication context, dimensions of, 9–10 Communication event, 153–73 conversational breakdown, 170–73 conversational initiation, 155–56 conversation and topic maintenance, 158–60 conversation and topic termination, 169–70 social versus nonsocial, 154–55 topic analysis format, 162–65 topic duration, 161–62 topic initiation, 156–57 turn taking, 166–67 Community, interpreters and, 109–10 Comparative word-pairs, 308 Competence, 74, 114 Complete episodes, 226 Complex episodes, 226 Complex Sentence Development, 420–21 Complex sentences, 211, 212 Comprehension, 28 autism spectrum disorder and, 53 intervention for, 392–94 learning disability and, 36 narrative, 299 neglect and abuse and, 59 reading, deficits in, 379 semantic, 315–19 specific language impairment and, 43 traumatic brain injury and, 56 Comprehensive Receptive and Expressive Vocabulary Test, 88 Comprehensive Test of Phonological Processing (CTOPP), 384 Computer activities, in language therapy, 337 Computer-assisted language analysis (CLA), 214–15 Concussion, 55 Conjunctions, 152–53, 213, 310–11 acquisition order of, 312 in narratives, 232 word relationships and, 188

552

Subject Index

Construct validity, 73 Content, 184–91 figurative language, 190–91 generalization, 12 inadequacies, 295 lexical terms, 185–87 validity, 73 word finding, 191 word relationships, 187–90 Context generalization, 12 Contexts influence on language, 248 language, 123–24 linguistic, 269–79 managing, 267–81 nonlinguistic, 267–69 top-down teaching, 279–81 Contextual support, 129 Contingencies, 16 intervention, 262–63 with no response, 274–76 pragmatic, 263 requiring response, 276–79 semantic, 262 Contingent query, 278 Continuant, 274 Contrastive stress, 153 Contrast training, 251 Conversation abilities, 288–95 context of, 264–65 entering into, 290 evocative techniques, 128–30 frequency and success rate, 156 frequency of contingency, 158–59 initiation of, 155–56 latency of contingency, 159–60 methods, 14, 156 presupposition, 290–91 referential skills, 291–94 repair, 294–95 roles, 147 specific language impairment and, 44 termination, 169–70 topic initiation, 156 topic maintenance and, 158–60 turn taking, 161, 164, 294

word finding in, 35 Conversational breakdown, 170–73 conversational repair, 171–73 repair requests, 170–71 Conversational contingencies, 276–79 hierarchy of, 280 Conversational partners, 126–27, 173–75 Conversational repair, 294–95 spontaneous versus listener-initiated, 172–73 word-finding errors, 173 Conversational sampling, 97 Conversational style, of caregivers, 255–58 CORE model, 388, 393 Correction model/request, 276 Criterion-referenced approach, 71 norm-referenced versus, 71 Criterion validity, 73 Critical thinking, 354 Cues direct linguistic, 272–73 indirect linguistic cues, 273 nonverbal, 262 training, 262–63 verbal, 262 Culturally linguistically diverse (CLD) background, 100 alternative assessment, 110–11 children from, 199, 201, 259–62 considerations for, 410–17 English-only classroom for, 334 families from, 259–62 guidelines for interacting with families from, 260 integrated model for assessment, 111–20 language sampling of children, 137–38 narrative analysis and, 233–34 reading and, 379–80 total physical response for, 334 Culture awareness, growth of, 102–4 definition of, 102 education in, 104–6 unfamiliarity with, 101–2 C-units, 195–97 examples, 195 Curriculum, de facto, 348 Curriculum-based assessment, 348 Curriculum-based intervention, 353–58

Subject Index

D Data analysis in reading assessment, 383–84 in spelling assessment, 402–3 in writing assessment, 400–401 Databases, 19 Data collection in reading assessment, 380–82 in spelling assessment, 401–2 in writing assessment, 400 Deafness, 62–63 Decoding, 377 De facto curriculum, 348 Deixis, 134–36 Density, 154 of turns, 168 Derivational suffixes, 95 Descriptive approach, 80–83 psychometric versus, 71–73 reliability, 81 validity, 81 Descriptive sequences, 225 Determiners, 204 Developmental Sentence Scoring (DSS), 420, 421–32 Black English and, 434–41 expected scores and ages, 430 language sample analysis with, 429 modification for CLD children, 432 scoring categories and point values, 422–27 Diagnostic and Statistical Manual on Mental Disorders (DSM-IV-TR), 48 Diagnostic categories, of language impairments, 22–33 Diagnostic Evaluation of Language Variance, 91 Dialects, 104–6 children with, 118–20, 336 Diana v. Board of Education, 100, 106 Digraphs, 401 Diphthongs, 401 Directive style, 256 characteristics of, 257 Direct linguistic cues, 272–73 Direct magnitude estimates (DME), 120 Discourse levels of, 363 mode of, 10 organization, 136

Discrimination, 24, 31, 33 Disruptions analysis categories, 180–81 intentions, 179 in language use, 178–79 Double-naming technique, 92 Down syndrome (DS), 27, 28 jargon and, 28 Duration, 154 of turns, 168 Dynamic assessment, 113 Dysgraphia, 399 Dyslexia, 36, 379 E Early intervention, 54 Early literacy questionnaires, 380 screening, 383 Echolalia, 8, 52 Education, in culture, language, language development, 104–6 Educational changes, functional intervention and, 340–43 collaborative teaching, 342–43 inclusion, 341–42 Elicited language analysis procedure, 96–97 Ellipsis, 152, 231 Emotional abuse, 58 Emotional awareness, 288 Emotional neglect, 58 Encoding, 184 English-only classroom, 334 Entity approach, 8 Episodes, 224 abbreviated, 226 complete, 226 complex, 226 interactive, 226 Error repetition/request, 278 Ethnographic analysis, 155 Evaluations, 229 Evidence-based practice (EBP), 4, 17–19, 376, 385 decision-making process in, 18 Evocative conversational techniques, 128–30 Executive functions, deficits in, 398 Expository writing, 352, 405–6

553

554

Subject Index

Expressive elaboration, 227–28 appendages, 229 evaluations, 229 in narratives, 229 orientations, 229 Expressive Vocabulary Test, 107 Extrinsic variables, 191 F Facilitative style characteristics of, 257 Families from CLD backgrounds, 259–62 functions of, 258 interaction in, 258 interpreters and, 109–10 life cycle of, 259 structure of, 258 Family-centered intervention, 258–59 Fetal alcohol spectrum disorder (FASD), 39, 40 Fetal alcohol syndrome (FAS), 39 interventions for, 40 Figurative language, 190–91, 319–21 Figure-ground perception, 35 Focused stimulation, 270 Focused temporal chains, 222 Formalist view of language, 8 Formal testing, 87–90 Fragile X syndrome (FXS), 27, 52 Frames, narrative, 218 Frequency, 154 of contingency, 158–59 in conversation, 156 of intentions, 179–83 Fullerton Language Test for Adolescents, 88 Functional language intervention, 4, 6, 8, 242, 340–74 classroom model, instituting, 370–74 classroom model elements, 346–70 educational changes and, 340–43 speech-language pathologist and, 344–46 traditional models versus, 7, 243 Functions, illocutionary, 130 G Gender differences, autism spectrum disorder and, 48 Generalization, 7, 403 content, 12 context, 12

contingencies, 16 definition of, 10 designing plan, 248 language facilitators, 15 plan format, 249 role in intervention, 10–17 schematic, 11 training cues, 15 training location, 16–17 training targets, 13 variables affecting, 11–13 Generalization variables, 248–65 training items, 250–52 training method, 252–55 training targets, 248, 250 General thinking, 354 Gestalt, 54 Grammar, 405 African American English (AAE) versus Standard American English, 412–13 Asian English versus Standard American English, 417 Latino English versus Standard American English, 415 Graphemes, phoneme-grapheme relationships, 392 Graphophonemic strategies, 393 Gray Oral Reading Test, 380 Group projects, 353 Guided reading, 387 H Head Start, 104, 385 Heaps, 221 High-functioning autism (HFA), 50, 51 conversational ability and, 289 High-point analysis, 222–24 Holistic approach, 8. See also Systems approach Homonyms, 303 Hyperactivity, 34 Hyperarousal, 58 Hyperlexia, 51 I Idioms, 319–20 IFSP. See Individualized Family Service Plan (IFSP) Illocutionary functions, 130–34. See also Intentions in children, 182–83 Imaginative language, 359 Imitation, 271, 274

Subject Index

Inadequate vocabulary, 300–303 Incidental teaching, 16 Inclusive schooling, 341–42 Indirect elicitation techniques, 446–47 Indirect linguistic cues, 273 Individualized educational plans (IEP), 342 Individualized Family Service Plan (IFSP), 259 Infants, Individualized Family Service Plan (IFSP) for, 259 Infinitives interventions with, 332–33 specific language impairment and, 44 Inflectional suffixes, 95, 323 Information, requests for, 285, 366 Information processing, 24–26 attention, 24, 31, 33 discrimination, 24, 31, 33 memory, 24, 25, 31–32, 33 organization, 24, 25, 31, 33 schematic representation of, 24 Information-processing deficits, assessment of, 98 Initiation, topic, 162–63 Initiators, 204 INREAL/Outreach Program of the University of Colorado, 85 Integrated functional assessment strategy, 83–98 formal testing, 87–90 observation, 85, 87 questionnaire, interview, and referral, 84–85 Integrated model for assessment, 111–20 children with different dialects, 118–20 of children with LEP, 112–18 Integration figure-ground, 35 sensory, 35 Intellectual disability, 26. See also Mental retardation causal factors related to, 30 Down syndrome, 27, 28 fragile X syndrome, 27 language characteristics of children with, 28 severity of, 27 techniques for, 33 Intelligibility, 81–82 Intentionality, 114 Intentions, 130–34 age of mastery and, 183 answering/responding, 132 appropriateness of, 183–84

555

calling/greeting, 132 continuance, 132 elicitation protocol for, 131 expressing feelings, 132 frequency and range, 179–83 fulfilling, 274 hypothesizing, 132 in language use, 179–84 making choices, 132 predicting, 132 protesting, 132 reasoning, 133 repeating, 133 replying, 133 reporting, 133 requesting assistance/directing, 133 requesting clarification, 133 requesting information, 134 requesting objects, 134 requesting permission, 134 Interactive episodes, 226 Interference, 105 Interjudge reliability, 72 Interlanguage, 148 Internal consistency, 72 Interpersonal variables, 13 Interpreters relationship with family and community, 109–10 selection, 108 training, 108–9 use of, 108–10 Intervention, 242–65 activities, 450–52 for children with CLD backgrounds, 333–36 child’s involvement in, 247 child’s lead in, 246–47 context and, 247 contingencies, 262–63 cultural beliefs and, 259–62 curriculum-based, 353–58 developmental guidelines, 244–46 evidence-based practice, 17–19 family-centered, 258–59 for fetal alcohol syndrome, 40 functional language model, 242, 340–74 generalization, role in, 10–17 generalization plan, 248 generalization variables, 248–65

556

Subject Index

Intervention (cont.) goals, 78–79 with infinitives, 332–33 language arts and, 345–46 language facilitators, 15, 243–44, 255 linguistic awareness, 358–64 location, 264–65 for memory, 49 microcomputers, 336–37 morphology, 322–31 natural learning, 244 for phonological awareness, 390–92 pragmatics, 283–99 principles, 243–48 for reading impairment, 385–96 scripts in, 247–48 semantics, 299–322 for spelling, 406–7 strategy-based model, 358 syntax, 322–31 training cues, 15, 262–63 training items, 13–14 training targets, 13 for writing impairment, 403–7 Interviews, 84–85 face-to-face, 85 format, 86 questions for LEP children, 112–13 Intonation, 443 Intrapersonal variables, 12–13 Intrinsic variables, 191 Invented rule, 114 Irregular verbs, 245 age of acquisition of, 208 Isolated therapy model, 341 J Jargon, 28, 295 L Language aspects of, 9 assessing aspects of, 90–95 communication context, dimensions of, 9–10 contexts, 123–24, 248 delay, 431 education in, 104–6 elicitation, 138, 268–69 figurative, 190–91, 319–21

form, 137 formalist view of, 8 functions, 130 imaginative, 359 noninformative, 150 quantitative measures of, 194 remediation, 346 targets, 454–56 unfamiliarity with, 101–2 Language analysis methods, 420–41 Language arts, language intervention and, 345–46 Language-based reading disabilities checklist, 381–82 Language characteristics of autism spectrum disorder, 51–52 of cerebrovascular accident, 57 of language learning disability, 35–37 maltreatment and, 59 of mental retardation, 27–29 of pervasive developmental disorder, 51–52 of specific language impairment, 42–45 of traumatic brain injury, 55–56 Language development education in, 104–6 in preschool-age children, 202–3 Language disorder, ASHA definition of, 4 Language facilitation, 365–70 classroom requirements, 365–67 peers as facilitators, 367–70 talking with children, 367–70 Language facilitators, 15, 255 parents as, 264 as reinforcers, 243–44 Language form, 192–215 computer-assisted language analysis, 214–15 quantitative measures, 192–97 syntactic and morphological analysis, 197–213 Language impairment (LI), 4, 22–65 autism spectrum disorder (ASD), 48–54 brain injury, 55–57 childhood schizophrenia, 61–62 children with, 348 deafness, 62–63 definition of, 5 diagnostic categories, 22–33 implications, 64–65 information processing, 24–26 language learning disability, 34–41 language learning requirements, 63 late talkers, 61

Subject Index

maltreatment and, 57–61 mental retardation, 26 narrative retelling and, 219 nonspecific language impairment, 61 otitis media, 62 pervasive developmental disorder, 48–54 prenatal drug and alcohol exposure, 39–41 referral form for, 347 selective mutism, 62 specific language impairment, 41–48 Language learning, components of, 22 Language learning disability (LLD), 34–41 biological factors, 37–38 causal factors, 37–38 language characteristics, 35–37 processing factors, 38 social-environmental factors, 38 writing and, 397–98 Language sampling, 122–44 analysis methods, 178 with children with CLD backgrounds, 137–38, 139 collecting written samples, 143 contexts, 123–24 conversational partners, 126–27 discourse organization, 136 intentions, 130–34 language form, 137 presuppositional and deictic skills, 134–36 recording, 138–39 representative sample, 122–23 semantic terms, 136–37 settings and tasks, 124–26 topics, 127–28 transcribing, 140–43 Language use, 177–84 disruptions, 178–79 intentions, 179–84 Larry P. v. Riles, 100, 106 Latency, 154 of contingency, 159–60 of turns, 168 Late talkers, 61 Latino English, 413–15 Lau v. Nichols, 100 Learning natural, 244 styles, 254 Learning disability (LD), 34 fetal alcohol syndrome and, 40

557

language characteristics of, 36 spelling and, 406 techniques for, 39 writing and, 398 Letter-sound knowledge, 391 Lexical terms, 185–87 in narratives, 232 over-/underextensions and incorrect usage, 187 style and lexicon, 187 type-token ratio, 185–87 Lexicon, 187 Limited English proficiency (LEP), 100 children with, 112–18 interview questions for, 112–13 morphological errors of, 201 Linguistic awareness intervention, 358–64 Linguistic contexts, 269–79 contingencies, 274–79 direct cues, 272–73 indirect cues, 273 modeling, 270–72 Linguistic devices, 150–51 definite and indefinite references, 151 deictics, 150–51 Linguistic standard, 336 Literacy disabilities, 376 Literature, children’s, 362, 453–66 Location conversational context, 264–65 of intervention, 264–65 physical, 264 training, 16–17 M Magnetic resonance imaging (MRI), 45 Main idea, identifying in reading, 394–96 Maltreatment, 57–61 biological factors, 59 causal factors, 59–60 language characteristics, 59 social-environmental factors, 60 Mand-elicited imitation (MEI) model, 301 Mand model, 273 Mazes, 179 Meaning, 114, 300 Mean length of T-units in words (MLT-W), 229 Mean length of utterance (MLU), 125, 138, 192–94, 420 Mean syntactic length (MSL), 194

558

Subject Index

Mediated language experience (MLE), 114, 235 examples of, 116 Mediation, 114 competence, 114 intentionality, 114 meaning, 114 transcendence, 114 Mediational strategies, 31 Memory, 24, 25, 31–32, 33 intervention for, 49 narratives and, 219 verbal working, 321–22 working, 25, 45, 47 writing and, 396 Mental retardation, 23, 26–32 biological factors, 29 causal factors, 29–32 conversational skills and, 292 language characteristics, 27–29 processing factors, 31–32 social-environmental factors, 29, 31 Metalinguistic abilities, 64 Metapragmatics, 363–64 Microcomputers, 336–38 language therapy, use in, 337–38 Mnemonic strategies, 313 Modal auxiliary verbs, 208, 326 Modeling, 270–72 Morphemes, 44, 94, 323 Brown’s fourteen, 198 counting rules, 193 mean length of utterance and, 192 order for teaching, 324 Morphological analysis, 197, 199–201 Morphology, 28, 322–31 assessment of, 94–95 autism spectrum disorder and, 53 definition of, 323 learning disability and, 36 neglect and abuse and, 59 prefixes and suffixes, 444 specific language impairment and, 43 traumatic brain injury and, 56 Motherese, 147 Mothers. See also Parents controlling, 60 conversational style of, 256 neglecting, 60

N Naming strategy, 93 Narration, 295–99 cohesion, 298–99 comprehension, 299 structure, 296–98 types of, 236 Narrative analysis, 217–37 children with CLD backgrounds and, 233–34 cohesive devices, 230–32 collecting narratives, 218–20, 235–36 definition of, 220–21 expressive elaboration, 227–28 high-point analysis, 222–24 microstructure, 230 narrative levels, 221–22 quantitative measures, 229 reliability and validity, 232–33 scripts and frames, 218 story grammars, 224–26 Narrative development, in preschool-age children, 361–62 Narrative levels, 221–22 centering, 221 chaining, 221 focused temporal chains, 222 heaps, 221 narratives, 222 sequences, 222 unfocused temporal chains, 222 Narratives, 222 elaboration in, 229 structural properties of, 227 Narrative writing, 352, 404–5 National Center for Evidence-Based Practice in Communication Disorders, 17 Natural learning, 244 Negatives, word relationships and, 190 Neglect emotional, 58 language impairment and, 57–61 physical, 58 Neutralist philosophy, 71 No Child Left Behind (NCLB), 376 Noninformative language, 150 Nonlinguistic contexts, 267–69 language elicitation and, 268–69 Nonsocial speech, 155

Subject Index

Nonspecific language impairment (NLI), 61 Nonverbal cues, 262 Nonverbal learning disability (NLD), 33 Normalist philosophy, 71 Normative testing criterion-referenced versus, 71 inappropriate norms, 77 incorrect assumptions, 78 intervention goals, 78–79 measuring therapy progress, 79 misuse of, 75–80 misuse of scores, 75–77 Normed standardized tests, 71 Norms, inappropriate, 77 Nouns, 204 elements of, 205 phrases, 204, 206, 330 Number of different words (NDW), in sample, 185, 229 O Object noun complements, 210 Objects, requests for, 285–86 Oblige, 167 Observations, 85, 87 features to note in, 87 Onsets, 387 Oral narration, 217 Organization, 24, 25, 31, 33 Orientation, 163, 229 Otitis media, 62 Overextensions, 187 Overlap, in turns, 169 P Parallel talk, 270 Parent-child interactions, 173 Parentese, 147 Parents. See also Mothers controlling, 60 functional assessment and, 84–85 interactive style of, 368 as language facilitators, 255, 264 neglecting, 60 reading activities and, 386 speech-language pathologists and, 345 Particles, 327 Passives, word relationships and, 190

559

PDD-NOS, 50 Peabody Picture Vocabulary Test (PPVT), 78, 89 Peers, as facilitators, 367–70 training, 369 Perceptual training, 314 Performance, 74 Perseveration, 28, 35, 181 Persuasive writing, parameters by age, 402 Pervasive developmental disorder (PDD), 48–54 biological factors, 52–53 causal factors of, 52–54 language characteristics, 51–52 processing factors, 54 schizophrenia and, 62 social-environmental factors, 53 Phenylketonuria (PKU), 29 Phoneme-grapheme relationships, 392 Phonemes, 390 Phonemic awareness, 391 Phonemic contrasts African American English (AAE) versus Standard American English, 410–11 Asian English versus Standard American English, 416 Latino English versus Standard American English, 414 Phonics, 379 Phonological awareness assessment of, 384 deficits in, 378–79 definition of, 378 intervention for, 390–92 Phonological Awareness Test (PAT), 384 Phonology, 28 autism spectrum disorder and, 53 learning disability and, 36 neglect and abuse and, 59 specific language impairment and, 43 traumatic brain injury and, 56 Phrases noun, 330 verb, 331 Physical abuse, 58 Physical location, 264 Physical neglect, 58 Picture-focus prompts, 388 Play, 359 replica, 368 sociodramatic, 368

560

Subject Index

Plurals, 328 Post-noun modifiers, 204 Pragmatic contingency, 263 Pragmatics, 28, 283–99 action requests, 285 assessment of, 91 attention, calling for, 284–85 autism spectrum disorder and, 53 conversational abilities, 288–95 definition of, 8 information requests, 285 intentions, 284–87 learning disability and, 36 narration, 295–99 neglect and abuse and, 59 object requests, 285–86 response to requests, 286–87 role in intervention, 8–10 specific language impairment and, 43 statements, 287 traumatic brain injury and, 56 Prefixes, 444 Pregnant pause, 184 Prenatal alcohol exposure, 39–41 Prenatal drug exposure, 39–41 Prepositions, 309, 329–30 word relationships and, 190 Preschool-age children assessment of, 70–98 assessment with language difference, 100–120 at-risk, identifying, 350 children’s literature for classroom, 454–66 conversational repair by, 171 Individualized Family Service Plan (IFSP) for, 259 language development in, 202–3 linguistic awareness intervention for, 359–62 mand model and, 273 morpheme counting rules for, 193 narrative retelling and, 220 nonsocial speech in, 155 questions, posing, 210 T-units and C-units for, 196 word order and, 315 Preschool Language Scale-3, 107 Presupposition, 28, 134–36, 149–50, 290–91 Primitive temporal narratives, 222 Print awareness, 386 Print-focus prompts, 388 Productivity, 81

Prognosis, 55 Pronouns, 305, 326, 327–28 analysis method, 200 subjective, 325 Protoverbs, 323 Proverbs, 319 Psychometric assessment protocols, 73–80 content, 74–75 descriptive versus, 71–73 misuse of normative testing, 75–80 test differences, 74 Public Law 99-457, 258 Pull-out therapy model, 341 Q Qualitative Reading Inventory-III, 382 Qualitative terms, 307–9 Quantitative measures, 192–97 mean length of utterance, 192–94 mean syntactic length, 194 of narrative analysis, 229 T-units and C-units, 195–97 Quantitative terms, 306–7 Questionnaires, 84–85 format, 86 Questions, 209–10 R Rapid automated naming (RAN), 384 Rapid naming, 316 Reaction sequences, 226 Reactivity, 82–83 Reading, 377–96 assessment, 380–85 children with CLD backgrounds and, 379–80 comprehension deficits, 379 guided, 387 intervention for impairment, 385–96 main idea, identifying, 394–96 phonological awareness deficits, 378–79 problems, 377–79 Reading assessment data analysis, 383–84 data collection, 380–82 Recasts, 45 Recast sentences, 275 Reference, 151–52, 300 anaphoric, 152 devices, 231

Subject Index

following mention, 152 initial mention, 151–52 Referential cohesion, 299 Referential communication, 148–51 linguistic devices, 150–51 presuppositional skills, 149–50 Referential skills, 291–94 topic duration, 293–94 topic initiation, 291–92 topic maintenance, 292–93 Referrals, 84–85 for language impairment, 347 Reflective pausing, 316 Register, 147–48 Regular Education Initiative (REI), 341 Reinforcement, 16 Relational words, 136, 306–11 conjunctions, 310–11 qualitative terms, 307–9 quantitative terms, 306–7 semantic categories and, 303–4 spatial and temporal terms, 309–10 Relative clauses, 211, 213 Reliability, 72 alternate form, 72 of descriptive approach, 81 interjudge, 72 of narrative analysis, 232–33 split-half, 72 test-retest, 72 Repair, conversational, 170–73 record of, 172 Repetition request, 278 Replica play, 359, 360, 368 Representativeness, 82 in conversational sample, 128 in sampling, 122–23 spontaneity, 82 stability of structure/function, 82 variability of context, 82 Requests for action, 285 for information, 285, 366 for objects, 285–86 response to, 286–87 Response, 167 Retelling, of stories, 298 Retrieval. See Memory Rimes, 387

561

Role playing, 284, 359–61 Role-playing activities, 135 Root words, 303 S Sampling, 97–98 conversational, 97 language, 122–44 representativeness, 122–23 Scaffolding, 136 Schizophrenia, childhood, 61–62 School administrators, speech-language pathologists and, 345 School-age children assessment of, 70–98 assessment with language difference, 100–120 at-risk, identifying, 348–53 lexical items for, 185 linguistic awareness intervention for, 362–64 morphological development in, 323 T-units and C-units for, 196 written language samples, 143 Scores, misuse of, 75–80 Scripts, 124, 218 events providing, 247–48 sociodramatic, 361 Second-language learning, 104–6 Selective mutism (SM), 62 Self-correction, 276, 278 Self-questioning, 393 Self-talk, 270 Semantic alternates, 316 Semantic contingency, 262 Semantic Elaboration Coding System, 231 Semantic networking, 395, 396 Semantics, 28, 299–322 assessment of, 91–93 autism spectrum disorder and, 53 categories and relational words, 303–4 classes, 305 comprehension, 315–19 figurative language, 319–21 inadequate vocabulary, 300–303 learning disability and, 36 neglect and abuse and, 59 relational words, 306–11 specific language impairment and, 43 traumatic brain injury and, 56

562

Subject Index

Semantics (cont.) verbal working memory, 321–22 word retrieval and categorization, 311–15 Sensory integration, 35 Sensory modulation dysfunction (SMD), 50, 58 Sentence point, 428 Sentence types, 209–10, 330–31 complex, 211, 212 interrogatives, 209 negative, 210 recast, 275 Sequences, 154, 222 action, 225 descriptive, 225 reaction, 226 Service delivery, 101–7 awareness, growth of, 102–4 lack of preparation and experience, 101 unfamiliarity with language and culture, 101–2 Settings, for language sampling, 124–26 Sexual abuse, 58 Shading, 169 Signal inadequacies, 295 Sniglets, 302 Social disinhibition, 55 Socialization, language and, 259 Social speech, 154–55 Sociodramatic play, 368 SOUL acronym, 85 Spatial terms, 309–10 Specific language impairment (SLI), 41–48 biological factors, 45 causal factors, 45–47 intervention for memory, 49 language characteristics of, 42–45 neurological processing, 47 processing factors, 46–47 social-environmental factors, 45–46 Speech community, 10 nonsocial, 155 social, 154–55 Speech-language pathologist (SLP), 5 classroom teachers and, 344–45 in-service training with teachers, 371–72 language facilitation and, 365–70 language intervention and language arts, 345–46 linguistic awareness intervention in classroom, 358–64 parents and, 345

role of, 344–46 school administrators and, 345 Speech recognition software, 404 Spelling analysis, levels of, 402 assessment, 401–3 deficits, 398–99 Horn Method, 406 intervention, 406–7 8-Step Method, 407 5-Step Study Strategy, 406 Spidergram, 304 Split-half reliability, 72 Standard American English, 110, 233 African American English (AAE) versus, 410–13 Asian English versus, 416–17 Latino English versus, 413–15 Standard deviation, 229 Standard error of measure, 76–77, 78 Standardized tests, 71 nonbiased, 106 normed, 71 Statements, 287 Stay, play, talk principles, 369 Stories, retelling, 298 Story grammars, 221, 224–26 action sequences, 225 analysis, 228 descriptive sequences, 225 elements of, 224–25 examples, 225 Strategy-based intervention model, 358 Structures task, script for, 118–19 Study skills, 354 Style, 187 Style switching, 147 activities, 364 Stylistic variations, 147–48 channel availability, 148 interlanguage and code switching, 148 register, 147–48 Subjective pronouns, 325 Subject matter, 163 Subjects, 305 Substitution, 231, 353 Sudden infant death syndrome (SIDS), 40 Suffixes, 95, 444 derivational, 95 inflectional, 95, 323

Subject Index

Synonyms, 303 Syntactic analysis, 201, 204, 206–11, 213 embedding and conjoining, 210–11, 213 noun phrase, 204, 206 sentence types, 209–10 verb phrase, 206–9 Syntax, 28, 322–31 articles, 328–29 assessment of, 94 autism spectrum disorder and, 53 learning disability and, 36 neglect and abuse and, 59 plurals, 328 prepositions, 329–30 pronouns, 327–28 specific language impairment and, 43 traumatic brain injury and, 56 verb tenses, 323–27 word order and sentence types, 330–31 Systematic Analysis of Language Transcripts (SALT), 140, 433 Systems approach, 8. See also Holistic approach Systems model, 358 T Targets, training, 13 Tasks, for language sampling, 124–26 Teachers in-service training with SLP, 371–72 interactive style of, 368 Temporal terms, 309–10 Test of Adolescent and Adult Language, 4e., 89 Test of Auditory Comprehension of Language (TACL), 79, 89 Test of Early Reading Ability, 380, 382 Test of Language Development-Intermediate (TOLDI), 77, 90 Test of Narrative Language, 90 Test of Word Finding, 2e. (TOWF-2), 92 Test of Written Language, 401 Test of Written Spelling, 401 Test-retest reliability, 72 Tests cloze, 95 differences, 74 formal, 87–90 modification of, 95–97 normative, misuse of, 75–80 selection, variables in, 79

563

standardized, 71 Therapy computer activities in, 337 progress, 79 Top-down teaching, 279–81 Topic analysis aspects of, 162 analysis format, 162–65 appropriateness of, 157 definition of, 156 duration, 161–62, 293–94 frequency and success rate, 157 informativeness, 161 initiation, 156–57, 162–65, 291–92 for language sampling, 127–28 maintenance, 163–65, 292–93 outcome, 163 rating, 166 sequencing, 162 subject matter and orientation, 163 termination, 169–70 types of, 162, 163 Total number of words (TNW), in sample, 186, 229 Total physical response (TPR), 334 materials for, 335 Training analogical reasoning skills, 355–57 contrast, 251 cues, 15, 262–63 in-service for SLP and teachers, 371–72 of interpreters, 108–9 for intervention, 252–55 items, 13–14 location, 16–17 method, 14 of peer facilitators, 369 perceptual, 314 reinforcement, 16 targets, 13, 248, 250 verbal, 314 Train-test-train procedure, 351 Transcendence, 114 Transcription, of language sample, 140–43 Transfer, 32 Traumatic brain injury (TBI), 55–57 causal factors, 56–57 language characteristics, 55–56 T-units, 195–97, 229 examples, 195

564

Subject Index

Turnabouts, 279 variety of, 293 Turn taking, in conversation, 161, 164, 166–67, 294 continuous, 165 density, 168 discontinuous, 165 duration of, 168 informativeness of turn, 165 latency, 168 overlap, 169 rating, 166 types, 168 Type-token ratio (TTR), 185–87 U Underextensions, 187 Unfocused temporal chains, 222 Utterance, 141 boundaries, 142 pairs, 161 V Validity, 72 construct, 73 content, 73 criterion, 73 of descriptive approach, 81 intelligibility, 81–82 of narrative analysis, 232–33 productivity, 81 reactivity, 82–83 representativeness, 82 Variables child, 128 extrinsic, 191 generalization, 248–65 interpersonal, 13 intrapersonal, 12–13 intrinsic, 191 in test selection, 79 Verbal cues, 262 Verbal training, 314 Verbal working memory, 321–22 Verb phrase, 206–9 elements of, 207 Verbs aspect, 208 auxiliary, 325, 326

irregular, 207, 208, 245 modal auxiliary, 208, 326 phrases, 331 specific language impairment and, 44 Verb tenses, 323–27 future, 326 past, 325 present progressive, 326 Video recording, 139 Vocabulary, 185 fast-mapped, 300 inadequate, 300–303 teaching techniques, 301 Vowels, 391–92 W Wide Range Achievement Test–3, 401 Wilson Word List, 391 Woodcock Reading Mastery Test-Revised, 380 Word categorization, 311–15 Word finding, 191 difficulties, 191, 311 Word inventories, 401 Word order, 315, 330–31 Word-prediction programs, 404 Word relationships, 187–90 intrasentence, 188, 190 semantic categories, 188–89 Word retrieval, 311–15 difficulties, 36 oral questioning modifications for, 317 strategies, 316 Word-structure patterns, 443 Word Test Adolescent, 90 Word Test Elementary, 90 Working memory, 25, 45, 47 verbal, 321–22 World knowledge, 315 Writing, 397–407 analysis, levels of, 402 assessment of, 399–403 computer programs for, 403 executive function deficits, 398 expository, 352, 405–6 intervention for impairment, 403–7 memory and, 397 narrative, 352, 404–5 opinion, 405

Subject Index

persuasive, 401 problems, 397–99 spelling deficits, 398–99 Writing assessment, 399–403 data analysis, 400–401

data collection, 400 spelling, 401–3 Z Zone of proximal development, 114

565